Case #4 - A Child With Painless Wounds

Janaina Nogueira, MD, Janice Ford, MD, Mary Mancao, MD, Paul Maertens, MD

Disclosures

March 17, 2003

Discusson

HMSN-type II neuropathy (Charcot-Marie-Tooth [CMT] disease)

The patient was discharged from the hospital after 5 days, with arrangements to continue appropriate IV antibiotic therapy as an outpatient for a total of 6 weeks. She was scheduled to receive wound care as needed.

Due to failure of the great toe wound to heal following treatment failure of a second course of antibiotic therapy for the osteomyelitis, the patient was readmitted 3 months after initial discharge for a left great toe amputation.

CMT is one of the most common inherited neurologic disorders, affecting approximately 1 in 2500 people in the United States. The disease is named for the 3 physicians who first identified it in 1886 - Jean-Marie Charcot and Pierre Marie from Paris, France, and Howard Henry Tooth, from Cambridge, England. CMT, also known as hereditary motor and sensory neuropathy (HMSN) or peroneal muscular atrophy, is the most frequent hereditary neuropathy affecting the peripheral nervous system.[1,2,3,4]

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