Host factorConsiderations
Diabetes mellitusHigher incidence of mixed and pure gram-negative organisms (approaching 30 to 40 percent) requiring use of broader spectrum antibiotics. Susceptible to more severe infections and more likely to require surgical intervention. Patients on renal dialysis pose the highest risk.8
Immunocompromised state (patients on immunosuppressive therapy and patients with HIV infection or AIDS)More susceptible to opportunistic infections.
Pyogenic flexor tenosynovitis as well as cutaneous abscesses are known potential sequelae of disseminated Neisseria gonorrhoeae and are more common in patients who are immunocompromised.1,3,5
Candidal flexor tenosynovitis infection has been reported in patients who are immunocompromised.7
Intravenous drug useMixed aerobic and anaerobic hand infections are common and usually caused by oral pathogens. Patients commonly present with subcutaneous abscesses and tendon sheath infections. They require the use of broader spectrum antibiotics.14
Tropical fish aquarium exposureThe culprit organism is more likely to be Mycobacterium marinum. This organism is quite fastidious and often responsible for chronic, indolent hand infections.9
Possible sexually transmitted disease exposureFlexor tenosynovitis as well as cutaneous abscesses are known potential sequelae of disseminated N. gonorrhoeae infection.1,3,5,6,10