Gentamicin is a type of aminoglycoside
produced by the fermentation of bacteria widely present in the environment.
Because of its widespread use and abuse, their toxic effects have become more
obvious and sometimes bizarre.
Toxic effects involve the kidneys, ears and
rarely neuromuscular junction as well as neurovascular bundles leading to ischemia and
tissue necrosis.
I present a 32-year old apprentice who developed bluish to black discoloration
of the terminal phalanx of the index, middle, ring and little fingers of both
hands following several injections of gentamicin.
Digital necrosis arising from injection of
gentamicin is rare in the scientific literature. Adverse effects of
aminoglycosides can be prevented through proper regulation of its use.
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