Extensive Synovitis in an Operated Case of Distal Radius Fracture Caused by Sphingomonas paucimobilis; Culture the Biopsy – Biopsy the Culture

Gram-negative bacterium that has affinity for bones and soft tissues. It usually tends to affect the immunocompromised and those who have undergone surgical procedures. A 36-year-old male presented with extensive synovitis over the wrist which was attributed to the prominent distal radius plate. The blood investigations were negative for infection and ultrasonography was suggestive of tenosynovitis and no collection. Tenosynovestomy was done along with plate removal. The soft-tissue samples were sent for culture – sensitivity and histopathological evaluation. This case highlights the importance of doing culture and sensitivity for every case soft-tissue involvement. The culture grew S. paucimobilis which was managed with appropriate intravenous antibiotics. This report highlights the significance of considering unusual causative agents in tenosynovitis cases and tailoring treatment based on culture results and also the importance of sending the samples to histopathology and microbiology.