Palm atheroma infection caused by Raoultella planticola

Description

A 74-year-old man presented to the emergency department with pain in the left hand. He had a history of lung carcinoma and was treated with chemotherapy for 2 years. On physical examination, his left hand was found to exhibit swelling and redness. There was an atheroma at the base of his middle finger, which was the most painful area (figure 1-A,B). He was prescribed cephalexin 2 g daily and ordered to see an orthopaedic surgeon the next day. However, the next day, his left hand became worse. There was increased swelling, redness, pain and pus (figure 1-C,D). The patient was treated with surgical drainage and intravenous cefazolin 2 g daily to control the infection (figure 2). A week later, bacterial isolation analysis revealed that the causative agent was Raoultella planticola. He was switched to ceftriaxone based on sensitivities and prior literature on the...

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