• Tao Wang, Gang Zhao, Yong-Jun Rui, Zheng-Feng Lu, and Jing-Yi Mi.
• Department of Hand Surgery, Wuxi No. 9 People's Hospital Affiliated to Soochow University, Wuxi, China.
• Medicine (Baltimore). 2017 Dec 1; 96 (48): e8992.

IntroductionWhitlow is a common disease in clinic, characterized by pain and swelling of finger. However, few articles had reported on extensive infection in the forearm caused by whitlow infected by mycobacterium tuberculosis (MTB).Patient ConcernsA 70-year-old Chinese female complained of fester in back of left hand for 5 days. She had a history of recurrent whitlow for 14 months and pulmonary tuberculosis (TB). She received treatment in another hospital due to whitlow on July 2016. Then she was treated with incision and drainage. However, whitlow presented again several times before coming to our hospital. She came to our hospital on September 7, 2017 and x-ray of forearm showed that radius, ulna, and carpal were eroded.DiagnosesShe was diagnosed with left extensive infection in the forearm caused by whitlow infection by MTB.InterventionsConsidering her serious and extensive condition, we performed left forearm amputation on September 12, 2017. We collected some soft tissue cut down during surgery and conducted pathological examination. Finally, pathological result showed MTB infection. Then that patient was treated with antituberculosis therapy.OutcomesUp to now, illness condition has not progressed. A recent x-ray of forearm showed no osteolysis in humerus.ConclusionsExtensive infection in the forearm after recurrent whitlow infection by MTB is rare. So when we face recurrent whitlow, a rapid diagnosis and treatment are required to prevent complications. This case reminds us that recurrent whitlow is dangerous. Attention must be paid to recurrent whitlow. If necessary, amputation should be considered.

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