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A healthy 60-year-old woman presented with a painful left hand. She noted that she had pulled a splinter from her left thumb while on vacation three months previously. She reported no history of exposure to fish tanks, sea water, or fresh water. Despite two courses of treatment with antimicrobial agents and nonsteroidal antiinflammatory drugs, the initial inflammation and tenderness of her thumb had gradually progressed to diffuse swelling, tenderness, and stiffness of her entire left hand, wrist, and forearm. On examination, the patient appeared healthy and had a temperature of 37.1°C. Her left hand was diffusely swollen, and her fingers . . . [Full Text of this Article] |
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