Official websites use. Share sensitive information only on official, secure websites. Box , Honiara, Solomon Islands. Tropical diabetic hand syndrome TDHS is a rare and often unrecognized complication that can lead to lifelong disability or even death among diabetic patients living in the tropics.
The patient presented with symptoms of localized cellulitis of the fourth digit of the left hand after being discharged Subsequent physical exams, surgical debridement, and patient monitoring indicated that the cellulitis spread and developed into necrotizing fasciitis. Despite serial surgical debridement and a fasciotomy, as well as administration of antidiabetic agents and antibiotics, the patient developed sepsis and died forty-five days post-admission. Medication shortages, late presentation, and failure to pursue aggressive surgery increases risk of TDHS patient morbidity and mortality.
TDHS requires early detection and presentation, aggressive surgical management, and efficient administration of antidiabetic agents and intravenous antibiotics. Keywords: Diabetes mellitus, Tropical diabetic hand syndrome, Necrotizing fasciitis, Sepsis, Case report. Tropical diabetic hand syndrome TDHS is a rare acute condition affecting diabetic patients living in the tropics. Early identification, aggressive surgical intervention, and early administration of broad spectrum IV antibiotics are key.
Limited resource settings pose various challenges to the effective management of infection and TDHS. Access to medications, diagnostic equipment, and knowledge about identifying and treating TDHS may help reduce mortality.
Tropical diabetic hand syndrome TDHS is a term used to describe a condition occurring in tropical regions in which acute infection of the hand leads to localized swelling or cellulitis and subsequently to sepsis in diabetic patients [1] , [2]. This is a commonly unrecognized and underreported complication in the Pacific Region with most cases being reported in Africa or India [3] , [4].
