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A man with an infected finger: a case report.

Gathier PJ, Schönberger TJ - J Med Case Rep (2015)

Bottom Line: He had multiple vesicles on the finger, which led to the diagnosis of herpetic whitlow, which we confirmed by polymerase chain reaction testing.Whitlow is rarely caused by the herpes simplex virus, but this disease requires a swift recognition and treatment to prevent complications.This case serves to emphasise that not all whitlow is caused by a bacterial infection, and that it is important to differentiate between herpetic and bacterial whitlow, as these diseases require a different treatment.

View Article: PubMed Central - PubMed

Affiliation: Jeroen Bosch Ziekenhuis 's-Hertogenbosch, Henri Dunantstraat 1, 5223 GZ, 's-Hertogenbosch, The Netherlands. pjgathier@gmail.com.

ABSTRACT

Introduction: Whitlow is an infection of a finger or around the fingernails, generally caused by bacterium. However, in rare cases, it may also be caused by the herpes simplex virus. As herpetic whitlow is not seen often, it may go under-recognised or be mistaken for a different kind of infection of the finger. Delayed recognition and/or treatment puts patients at risk of complications ranging from superinfection to herpetic encephalitis.

Case presentation: A 23-year-old Caucasian man with no medical history was referred by his primary care physician because of erythema and swelling of the little finger of his left hand. The primary care physician had already treated him with the oral antibiotic Augmentin® (amoxicillin-clavulanic acid) and incision of the finger, but this had not resolved his complaints. He had multiple vesicles on the finger, which led to the diagnosis of herpetic whitlow, which we confirmed by polymerase chain reaction testing. All cutaneous abnormalities disappeared after treatment.

Conclusions: Whitlow is rarely caused by the herpes simplex virus, but this disease requires a swift recognition and treatment to prevent complications. This case serves to emphasise that not all whitlow is caused by a bacterial infection, and that it is important to differentiate between herpetic and bacterial whitlow, as these diseases require a different treatment.

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Patient's finger, radial view. Radial side of the patient's little finger, showing yellowish vesicles and erythema.
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Fig3: Patient's finger, radial view. Radial side of the patient's little finger, showing yellowish vesicles and erythema.

Mentions: We confirmed the erythema and swelling of the distal phalanx of his left little finger, with vesicles with a yellow translucent colour. From these vesicles, a clear fluid spontaneously discharged. There was no pus, bony tenderness or pain over his flexor tendons. The motion of his finger was unlimited, and he had no fever (Figures 3 and 4).Figure 3


A man with an infected finger: a case report.

Gathier PJ, Schönberger TJ - J Med Case Rep (2015)

Patient's finger, radial view. Radial side of the patient's little finger, showing yellowish vesicles and erythema.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4469579&req=5

Fig3: Patient's finger, radial view. Radial side of the patient's little finger, showing yellowish vesicles and erythema.
Mentions: We confirmed the erythema and swelling of the distal phalanx of his left little finger, with vesicles with a yellow translucent colour. From these vesicles, a clear fluid spontaneously discharged. There was no pus, bony tenderness or pain over his flexor tendons. The motion of his finger was unlimited, and he had no fever (Figures 3 and 4).Figure 3

Bottom Line: He had multiple vesicles on the finger, which led to the diagnosis of herpetic whitlow, which we confirmed by polymerase chain reaction testing.Whitlow is rarely caused by the herpes simplex virus, but this disease requires a swift recognition and treatment to prevent complications.This case serves to emphasise that not all whitlow is caused by a bacterial infection, and that it is important to differentiate between herpetic and bacterial whitlow, as these diseases require a different treatment.

View Article: PubMed Central - PubMed

Affiliation: Jeroen Bosch Ziekenhuis 's-Hertogenbosch, Henri Dunantstraat 1, 5223 GZ, 's-Hertogenbosch, The Netherlands. pjgathier@gmail.com.

ABSTRACT

Introduction: Whitlow is an infection of a finger or around the fingernails, generally caused by bacterium. However, in rare cases, it may also be caused by the herpes simplex virus. As herpetic whitlow is not seen often, it may go under-recognised or be mistaken for a different kind of infection of the finger. Delayed recognition and/or treatment puts patients at risk of complications ranging from superinfection to herpetic encephalitis.

Case presentation: A 23-year-old Caucasian man with no medical history was referred by his primary care physician because of erythema and swelling of the little finger of his left hand. The primary care physician had already treated him with the oral antibiotic Augmentin® (amoxicillin-clavulanic acid) and incision of the finger, but this had not resolved his complaints. He had multiple vesicles on the finger, which led to the diagnosis of herpetic whitlow, which we confirmed by polymerase chain reaction testing. All cutaneous abnormalities disappeared after treatment.

Conclusions: Whitlow is rarely caused by the herpes simplex virus, but this disease requires a swift recognition and treatment to prevent complications. This case serves to emphasise that not all whitlow is caused by a bacterial infection, and that it is important to differentiate between herpetic and bacterial whitlow, as these diseases require a different treatment.

Show MeSH
Related in: MedlinePlus