case_images: PMC4312609_01
case_images: Inflammatory nodules on the left hand on second admission.
case_images: CRIID2015-905920.001.jpg
case_images: PMC4312609_01_CRIID2015-905920.001.jpg
case_images: fig1
case_images: Patient was discharged home on trimethoprim/sulfamethoxazole oral tablets but readmitted seven days later with pain and pustules now mainly on all of the fingers of the left forearm (Figure 1).
case_images: MRI of the left arm showed multiple ulcerations extending from skin into subcutaneous fat with appearance concern for necrotizing fasciitis and osteomyelitis.
case_images: CRIID2015-905920.002.jpg
case_images: PMC4312609_01_CRIID2015-905920.002.jpg
case_images: fig2
case_images: Despite being adherent to this regimen for four weeks, he was ultimately readmitted a third time with new abscess formation on medial aspect of his proximal LUE and repeated MRI showing osteomyelitis of the left distal ulna (Figure 2).
case_images: Patient's left hand at his 9-month follow-up.
case_images: CRIID2015-905920.003.jpg
case_images: PMC4312609_01_CRIID2015-905920.003.jpg
case_images: fig3
case_images: Because of extensive disease and slow improvement on therapy, our patient received nine months of antibiotics therapy with good response (Figure 3).