What are the main types of finger infections. How can you identify different finger infections. What causes finger infections and swelling. When should you seek medical care for a finger infection. How are finger infections diagnosed and treated. How can you prevent finger infections at home.

Understanding Finger Infections: Types and Causes

Finger infections are a common problem that can range from mild to potentially serious. Early recognition and proper treatment are crucial to prevent permanent disability or loss of the finger. Let’s explore the six main types of finger infections, their causes, and key identifying features.

1. Paronychia: Infection Around the Fingernail

Paronychia is the most common bacterial infection seen in the hand. It affects the tissue at the edges of the fingernail and is usually superficial.

• Cause: Typically caused by staphylococcal and streptococcal bacteria, often entering through a hangnail or after biting off a piece of nail
• Symptoms: Redness and swelling around the fingernail, visible pus collection under the skin and nail, possible fluid leakage

2. Felon: Infection of the Fingertip

A felon is an infection located in the fingertip pad and its associated soft tissue.

• Cause: Usually results from a puncture wound that introduces bacteria deep into the fingertip pad
• Symptoms: Pain, swelling, and tenderness in the fingertip

3. Herpetic Whitlow: Viral Fingertip Infection

Herpetic whitlow is the most common viral infection of the hand, often misdiagnosed as paronychia or felon.

• Cause: Herpes simplex virus type I or II, often affecting healthcare workers or those with oral/genital herpes
• Symptoms: Painful, fluid-filled blisters on the fingertip

4. Cellulitis: Superficial Skin Infection

Cellulitis is a superficial infection of the skin and underlying tissue, usually on the surface of the hand or finger.

• Cause: Commonly staphylococcal and streptococcal organisms, entering through an open wound
• Symptoms: Redness, warmth, and swelling of the affected area

5. Infectious Flexor Tenosynovitis: Tendon Sheath Infection

This deep space infection involves the tendon sheaths responsible for flexing or closing the hand.

• Cause: Usually results from penetrating trauma that introduces bacteria into deep structures
• Symptoms: Pain, swelling, and difficulty moving the affected finger

6. Deep Space Infection: Multiple Structure Involvement

Deep space infections can affect one or several deep structures of the hand or fingers, including tendons, blood vessels, and muscles.

• Cause: Often due to puncture wounds or deep cuts introducing bacteria to deep tissue
• Symptoms: Severe pain, swelling, and limited finger movement

Recognizing Finger Infection Symptoms

Identifying the specific type of finger infection is crucial for proper treatment. Here are some key symptoms to watch for:

• Redness and swelling around the affected area
• Pain or tenderness, especially when touching or moving the finger
• Visible pus or fluid collection
• Difficulty moving the finger
• Warmth in the affected area
• Fever or general feeling of illness

Can finger infections spread to other parts of the body. While most finger infections remain localized, some can spread to deeper tissues or even enter the bloodstream if left untreated. This is why prompt recognition and treatment are essential.

When to Seek Medical Care for Finger Infections

Knowing when to consult a healthcare professional is crucial in managing finger infections effectively. Seek medical attention if you experience:

• Severe pain that doesn’t improve with over-the-counter pain relievers
• Rapidly spreading redness or swelling
• Fever or chills
• Pus drainage that doesn’t improve with home care
• Inability to move the affected finger
• Signs of a spreading infection, such as red streaks moving up the hand or arm

Is it safe to wait and see if a finger infection improves on its own. While minor infections may resolve with home care, it’s generally safer to have a healthcare professional evaluate any finger infection, especially if symptoms worsen or persist for more than a few days.

Diagnosis and Examination of Finger Infections

When you visit a healthcare provider for a suspected finger infection, they will likely perform the following exams and tests:

1. Physical examination: The doctor will carefully inspect the affected finger and hand, looking for signs of infection and assessing the extent of the problem.
2. Medical history: You’ll be asked about recent injuries, exposures, or activities that might have led to the infection.
3. Culture: In some cases, a sample of fluid or pus may be taken for laboratory analysis to identify the specific pathogen causing the infection.
4. Imaging studies: X-rays or other imaging techniques might be used to check for foreign bodies or to assess the involvement of deeper structures.

How do doctors differentiate between different types of finger infections. Doctors use a combination of visual examination, patient history, and sometimes laboratory tests to distinguish between various finger infections. The location, appearance, and progression of symptoms often provide important clues.

Treatment Options for Finger Infections

Treatment for finger infections varies depending on the type and severity of the infection. Here’s an overview of common treatment approaches:

Self-Care at Home

For mild infections, home care may be sufficient:

• Warm water soaks: Soak the affected finger in warm water for 10-15 minutes, 3-4 times a day
• Over-the-counter pain relievers: Acetaminophen or ibuprofen can help manage pain and reduce inflammation
• Elevation: Keep the hand elevated to reduce swelling
• Avoid further trauma: Protect the infected area from additional injury

Medical Treatment

More severe infections often require professional medical intervention:

• Oral antibiotics: Prescribed for bacterial infections
• Incision and drainage: For abscesses or fluid collections
• Antiviral medications: Used for herpetic whitlow
• Surgical intervention: In severe cases, especially for deep space infections
• Tetanus prophylaxis: May be recommended if the infection resulted from a puncture wound

How long does it take for a finger infection to heal with proper treatment. The healing time can vary depending on the type and severity of the infection. Mild infections may improve within a few days of treatment, while more severe cases can take several weeks to fully resolve.

Preventing Finger Infections: Essential Tips

Taking proactive steps to prevent finger infections can save you from pain and potential complications. Here are some key prevention strategies:

1. Practice good hand hygiene: Wash your hands regularly with soap and water, especially after potential exposure to bacteria or viruses.
2. Protect your hands: Wear gloves when working with chemicals, handling rough materials, or performing tasks that might cause cuts or punctures.
3. Avoid nail biting and cuticle picking: These habits can create entry points for bacteria.
4. Properly care for hangnails: Clip them carefully instead of pulling or biting them off.
5. Moisturize your hands: Keep your skin well-hydrated to prevent cracks that could allow bacteria to enter.
6. Treat cuts and scrapes promptly: Clean any wounds immediately and apply an antiseptic.
7. Maintain overall health: A strong immune system can help fight off potential infections.

Can certain occupations increase the risk of finger infections. Yes, people in occupations that involve frequent hand washing, exposure to chemicals, or contact with bodily fluids (like healthcare workers) may be at higher risk for certain finger infections. Extra precautions and proper protective equipment are essential in these professions.

Long-Term Outlook and Potential Complications

The prognosis for most finger infections is generally good when treated promptly and appropriately. However, it’s important to be aware of potential complications:

• Chronic pain or stiffness in the affected finger
• Sepsis (if the infection enters the bloodstream)
• Permanent tissue damage or scarring
• Loss of function in severe cases
• Recurrence of infection, especially in cases of herpetic whitlow

Do all finger infections require follow-up care. While minor infections may not need follow-up, it’s often recommended to have a healthcare provider reassess the infection after initial treatment. This helps ensure proper healing and allows for adjustments to the treatment plan if necessary.

Special Considerations for High-Risk Individuals

Certain groups of people may be more susceptible to finger infections or may experience more severe outcomes. These include:

• People with diabetes
• Individuals with compromised immune systems
• Those with peripheral vascular disease
• People who frequently work with their hands in wet environments
• Individuals with a history of finger infections

If you fall into one of these high-risk categories, it’s particularly important to practice good hand hygiene and seek medical attention promptly if you suspect a finger infection.

How should diabetic individuals approach finger infection prevention and care. Diabetic patients should be especially vigilant about hand care, maintain good blood sugar control, and seek medical attention early for any signs of infection. Regular hand inspections and moisturizing are also crucial for this group.

Emerging Research and Future Treatments

The field of hand and finger infection treatment continues to evolve. Some areas of ongoing research and potential future developments include:

• New antibiotics to combat resistant strains of bacteria
• Advanced imaging techniques for earlier and more accurate diagnosis
• Novel wound healing technologies
• Improved antiviral treatments for herpetic whitlow
• Development of better preventive strategies for high-risk populations

What role might nanotechnology play in future finger infection treatments. Nanotechnology could potentially lead to more targeted drug delivery systems, allowing for more effective treatment with fewer side effects. It might also contribute to the development of advanced wound dressings that promote faster healing and prevent bacterial growth.

Understanding finger infections, their causes, symptoms, and treatments is crucial for maintaining hand health. By recognizing the signs early, seeking appropriate medical care, and following prevention strategies, you can protect your fingers from these painful and potentially serious conditions. Remember, your hands play a vital role in daily life, so taking care of them should be a top priority.

Finger Infections & Swollen Fingers: 6 Possible Causes

Written by WebMD Editorial Contributors

• Finger Infection Overview
• Finger Infection Causes
• Finger Infection Symptoms
• When to Seek Medical Care
• Exams and Tests
• Finger Infection Treatment – Self-Care at Home
• Medical Treatment
• Next Steps – Follow-up
• Prevention
• Outlook
• For More Information
• Multimedia
• Synonyms and Keywords
• More

Injury or infection to a finger or fingers is a common problem. Infection can range from mild to potentially serious. Often, these infections start out small and are relatively easy to treat. Failure to properly treat these infections can result in permanent disability or loss of the finger.

Early recognition and proper treatment of the following main finger infections will help prevent most of the serious outcomes.

• Paronychia: A paronychia is an infection of the finger that involves the tissue at the edges of the fingernail. This infection is usually superficial and localized to the soft tissue and skin around the fingernail. This is the most common bacterial infection seen in the hand.
• Felon: A felon is an infection of the fingertip. This infection is located in the fingertip pad and soft tissue associated with it.
• Herpetic whitlow: A herpetic whitlow is an infection of the fingertip area caused by a virus. This is the most common viral infection of the hand. This infection is often misdiagnosed as a paronychia or felon.
• Cellulitis: This is a superficial infection of the skin and underlying tissue. It is usually on the surface and does not involve deeper structures of the hand or finger.
• Infectious flexor tenosynovitis: This infection involves the tendon sheaths responsible for flexing or closing the hand. This is also a type of deep space infection.
• Deep space infection: This is an infection of one or several deep structures of the hand or fingers, including the tendons, blood vessels, and muscles. Infection may involve one or more of these structures. A collar button abscess is such an infection when it is located in the web space of the fingers.

Bacteria cause most of these finger infections. The exception to this is the herpetic whitlow, which is caused by a virus. How the infection starts and is found in a particular location is what makes each specific type of infection unique. Usually some form of trauma is the initial event. This may be a cut, animal bite, or puncture wound.

• Paronychia: The offending bacteria are usually staphylococcal and streptococcal organisms. Rarely, a fungus causes this infection, which usually begins as a hangnail. Often a person will attempt to bite off the piece of nail that is at the corner. This results in an open wound that allows the bacteria found on the skin and the bacteria found in the mouth to infect the wound. The infection can then spread to the surrounding tissue next to the nail and cuticle.
• Felon: This bacterial infection of the finger pad, caused by the same organisms that cause paronychia, is usually the result of a puncture wound. The wound allows the introduction of bacteria deep into the fingertip pad. Because the fingertip has multiple compartments, the infection is contained in this area.
• Herpetic whitlow: The offending viral organism is the herpes simplex virus type I or II. This is the same virus that causes oral or genital herpes infections. People in certain occupations are more at risk for this infection. These include dentists, hygienists, physicians, nurses, or any other person who may have contact with saliva or body fluids that contain the virus. People with oral or genital herpes may also infect their own fingers.
• Cellulitis: The most common causes of this bacterial infection are staphylococcal and streptococcal organisms. This infection is usually the result of an open wound that allows the bacteria to infect the local skin and tissue. The infection can also spread to the hand and fingers by blood carrying the organisms.
• Infectious flexor tenosynovitis: This bacterial infection is usually the result of penetrating trauma that introduces bacteria into the deep structures and tendon sheaths, which allows the spread along the tendon and associated sheath.
• Deep space infection: This bacterial infection is usually the result of a puncture wound or deep cut that introduces the bacteria to the deep tissue. The collar button abscess is associated with the web space between the fingers. The deep structures of the hand create many potential compartments for an infection to invade.

Each of the main finger infections has specific signs and symptoms that make identification unique and can sometimes cause confusion if not properly evaluated.

• Paronychia: The area next to the fingernail will appear red and swollen. A visible collection of pus may be seen under the skin and nail. This fluid may be actually leaking out of the wound. The area will be tender and painful to the touch. The drainage from the area is usually a cloudy white-yellow color.
• Felon: The fingertip is swollen and painful. The swelling usually develops over several days and is located in the pad area of the fingertip. The area will have a throbbing pain and be painful to the touch. The area is usually red, and a visible collection of pus may be seen under the skin. The swollen area may have a portion that feels soft as if it contains fluid. As the swelling continues, the area may become tense or hard to the touch.
• Herpetic whitlow: The fingertip area will be red and tender. A burning or itching sensation may be present in the area. There may be mild swelling, but not as extensive as in the felon. There may be a single or many open wounds in the area affected. These open wounds often occur in clusters after the formation of a small blister-like lesion. The fluid in these lesions is usually clear in appearance but may be slightly cloudy. You may also have a low-grade fever and have swollen and tender lymph nodes in the area.
• Cellulitis: The area will be red and warm to the touch. The area may be slightly swollen and tender. This is usually a superficial infection, so the deep structures should not be involved. The motion of the fingers and hand should not be difficult or painful. If painful or difficult, this may indicate a deep space infection of some type.
• Infectious flexor tenosynovitis: Four major signs often are found with this condition. First is tenderness over the flexor or palm side of the finger. This pain is found over the tendons in the finger. Second is uniform swelling of the finger. Third is pain on extending or straightening of the finger. Fourth, the finger will be held in a slightly flexed or partially bent position. These signs are called Kanavel cardinal signs. All 4 signs may not be present at first or all at once.
• Deep space infections: The deep space infection that arises in the web space of the fingers is also called a collar button abscess. The space between the fingers will be painful and swollen. The area may also be red and warm to the touch. As the abscess becomes larger, the fingers will be slightly spread apart by the increasing pressure. The central area may have a soft spot that represents a collection of pus under the skin.

The key to preventing disability and possible loss of the finger is early and appropriate treatment. If any signs and symptoms are present, you should contact your doctor at once.

If you have signs or symptoms of a felon, cellulitis, infectious flexor tenosynovitis, or deep space infection, you should seek emergency care at once.

The correct diagnosis will start with a detailed history and physical exam. People who have a localized infection will be treated differently than someone with a severe infection. Coexisting problems such as diabetes or blood vessel disorders of the arms and legs will complicate the infection and may change the degree of treatment. 

• Important information that your doctor will need to know will include the following:
  • How did the injury or infection start?
  • When did this first occur or begin?
  • Where did it occur? Home? Work? In water? In dirt? From an animal or human bite?
  • Is it possible that a foreign body is in the wound?
  • What have you done to care for this before seeing your doctor?
  • When was your last tetanus shot?
  • Any previous injuries to the area?
  • Any other medical problems that you may have not mentioned?

• Specific information may help pinpoint the type of finger infection:
  • Paronychia: A history of nail biting may aid the diagnosis.
  • Felon: A history of a puncture wound or cut will aid the diagnosis. This would include a plant thorn. The doctor may obtain an x-ray to look for involvement of the bone or possible foreign body.
  • Herpetic whitlow: A history of contact with body fluids that may contain the herpes virus will aid the diagnosis. The diagnosis can often be made from the history and the appearance of the lesions. The presence of a clear fluid from the wounds may indicate a viral infection rather than a bacterial infection. A sample of the fluid may be analyzed by a Tzank smear, which will identify certain cells, indicating a viral cause.
  • Cellulitis: The doctor will need to consider other causes that may look similar such as gout, various rashes, insect sting, burns, or blood clot before the final diagnosis is made. An X-ray may be obtained to look for a foreign body or gas formation that would indicate a type of serious cellulitis.
  • Infectious flexor tenosynovitis: A history of a puncture wound or cut will aid the diagnosis. The presence of the 4 Kanavel cardinal signs is a strong diagnostic aid. A recent sexually transmitted disease may indicate a type of gonorrhea-related infection, which may resemble infectious flexor tenosynovitis.
  • Deep space infections: A history of puncture wound or other wound may aid the diagnosis. The finding of swelling between the fingers with a slow spreading of the involved fingers will help identify a collar button abscess.

Because finger infections have the potential to become severe, home care is limited. A very minor paronychia may be managed at home if you have no other complicating medical illness, such as diabetes. All of the other infections require urgent evaluation and treatment by a doctor. Because delay in treatment may result in disability or loss of the finger, you should not hesitate to obtain medical care.

A small, simple paronychia may respond to frequent warm water soaks and elevation of the hand. However, if no improvement is noticed in 1–2 days, you should see your doctor at once.

The mainstay of treatment for finger infections is antibiotics and proper wound care. This can range from a simple incision and drainage of the wound to an extensive surgical exploration of the wound to remove as much infected material as possible.

Some of the infections can be treated in a doctor’s office or clinic, but several will require inpatient treatment and IV antibiotics. Because the organisms that cause these infections are similar, many of the same types of antibiotics may be used.

• Paronychia: Often the wound may be treated with wound care alone. If a collection of pus is present, it will need to be drained. This may be done in several different ways. Commonly a scalpel is used to make a simple incision over the collection of pus to allow drainage. Or the scalpel may be inserted along the edge of the nail to allow drainage. If the infection is large, a part of the nail may be removed. If this procedure is required, the doctor will inject a local anesthetic at the base of the finger that will provide for a pain-free procedure. Most often, you will be placed on an oral antibiotic. You will then be instructed how to take care of the wound at home. (See paronychia.)
• Felon: Often, incision and drainage is required because the infection develops within the multiple compartments of the fingertip pad. Usually an incision will be made on one or both sides of the fingertip. The doctor will then insert an instrument into the wound and break up the compartments to aid in the drainage. Sometimes, a piece of rubber tubing or gauze will be placed into the wound to aid the initial drainage. The wound may also be flushed out with a sterile solution to remove as much debris as possible. These infections will require antibiotics. The wound will then require specific home care as prescribed by your doctor.
• Herpetic whitlow: Antiviral drugs such as acyclovir (Zovirax) may shorten the duration of illness. Pain medication is often needed. The wound must be properly protected to prevent a secondary bacterial infection and to prevent you from infecting other sites on your body or other people. Incision and drainage is not proper and, if done, may actually delay healing.
• Cellulitis: This infection is superficial, and oral antibiotics are usually sufficient. If the area is extensive or your immune system is weakened, then you may be treated in the hospital with IV antibiotics.
• Infectious flexor tenosynovitis: This is a surgical emergency and will require rapid treatment, hospital admission, and early treatment with IV antibiotics. Usually, the area will need to be surgically opened and all debris and infected material removed. Because of the intricate nature of the fingers and hands, a hand surgeon will usually perform this procedure. After surgery, several days of IV antibiotics will be required followed by a course of oral antibiotics.

• Deep space infections: Much like flexor infectious tenosynovitis, this can require emergency care. If the infection is mild, then only oral antibiotics may be needed. If more severe, a hand surgeon should evaluate the wound and IV antibiotics begun. Often these wounds will require incision and drainage followed by a course of antibiotics.

You need to understand the doctor’s instructions completely and ask any questions you have in order to thoroughly understand your care at home.

• If you have been prescribed antibiotics for a finger infection, you must follow the directions and take them for the prescribed time period.
• Often, your doctor will instruct you to keep your hand elevated to prevent swelling. This is important and needs to be done both during the day and night. By placing pillows next to you while sleeping, your hand can remain elevated.
• Wound care will often need to be continued at home. This may include daily warm water soaks, dressing changes, and application of antibiotic ointment. The different types of wound care are extensive. Your doctor should explain in detail.
• The finger or hand may be placed in a splint. This provides both immobilization and protection. It will be important to follow the instructions regarding the care of the splint. You will need to protect and properly care for the splint. You should closely monitor the finger or hand to watch for complications such as swelling or infection under the splint.
• Often, you will be asked to return to the doctor’s office in 24-48 hours. This may be necessary to remove packing or change a dressing. It is very important that you have close follow-up care to monitor the progress or identify any further problems.

Common sense safety practices will help prevent many of the finger wounds that become a problem. Simple things such as wearing protective work gloves may prevent injury. Wearing latex or vinyl gloves is mandatory if possible exposure to bodily fluids is expected. Avoid chewing on your nails, and wash your hands as needed. Seek early medical attention as soon as you think an infection is present.

If the infections are treated early and properly, the prognosis for full recovery is good. However, if treatment is delayed, or if the infection is severe, the prognosis is not as good.

• With the infections that involve deep structures such as infectious flexor tenosynovitis, even with the best care, the outcome may be less than desirable. Loss of function, loss of sensation, disfigurement, or even loss of the finger is possible.
• Your doctor will need to evaluate each case individually and present the likely outcome based on the findings.

See the following for related finger injuries:

• Broken finger
• Nail injuries
• Subungual hematoma (smashed fingernail, blood under the nail)
• Skier’s thumb (jammed thumb usually in a fall, fall on an outstretched hand)
• Dislocated finger
• Mallet finger (jammed finger, painful tendon injury, common sports injury)
• Onychomycosis (fungal infection of the fingernail or toenail)

Media file 1: Flexor tendon sheaths and radial and ulnar bursae. Image courtesy of Randle L Likes, DO.
 

Media type: Illustration

Media file 2: A herpetic whitlow. Image courtesy of Glen Vaughn, MD.

Media type: Photo

Media file 3: A moderate paronychia. Swelling and redness around the edge of the nail is caused by a large pus collection under the skin. Image courtesy of Christina L Kukula, DO.

Media type: Photo

Media file 4: Drainage of pus from a paronychia. Image courtesy of Glen Vaughn, MD.

Media type: Photo

Media file 5: A paronychia can progress to a felon if left untreated. Image courtesy of A paronychia can progress to a felon if left untreated. Image courtesy of Glen Vaughn, MD.

Media type: Photo

Media file 6: Anatomy of the fingernail. Top – The normal fingernail. Bottom – Nail bed laceration with subungual hematoma.

Media type: Image
 

paronychia, hangnail, onychia lateralis, onychia periungualis, felon, whitlow, herpetic whitlow, cellulitis, infectious flexor tenosynovitis, pyogenic flexor tenosynovitis, flexor tendosynovitis, tendosynovitis, deep space infections, collar button abscess, finger injury, finger infection, onychomycosis

Top Picks

Finger Infections & Swollen Fingers: 6 Possible Causes

Written by WebMD Editorial Contributors

• Finger Infection Overview
• Finger Infection Causes
• Finger Infection Symptoms
• When to Seek Medical Care
• Exams and Tests
• Finger Infection Treatment – Self-Care at Home
• Medical Treatment
• Next Steps – Follow-up
• Prevention
• Outlook
• For More Information
• Multimedia
• Synonyms and Keywords
• More

Injury or infection to a finger or fingers is a common problem. Infection can range from mild to potentially serious. Often, these infections start out small and are relatively easy to treat. Failure to properly treat these infections can result in permanent disability or loss of the finger.

Early recognition and proper treatment of the following main finger infections will help prevent most of the serious outcomes.

• Paronychia: A paronychia is an infection of the finger that involves the tissue at the edges of the fingernail. This infection is usually superficial and localized to the soft tissue and skin around the fingernail. This is the most common bacterial infection seen in the hand.
• Felon: A felon is an infection of the fingertip. This infection is located in the fingertip pad and soft tissue associated with it.
• Herpetic whitlow: A herpetic whitlow is an infection of the fingertip area caused by a virus. This is the most common viral infection of the hand. This infection is often misdiagnosed as a paronychia or felon.
• Cellulitis: This is a superficial infection of the skin and underlying tissue. It is usually on the surface and does not involve deeper structures of the hand or finger.
• Infectious flexor tenosynovitis: This infection involves the tendon sheaths responsible for flexing or closing the hand. This is also a type of deep space infection.
• Deep space infection: This is an infection of one or several deep structures of the hand or fingers, including the tendons, blood vessels, and muscles. Infection may involve one or more of these structures. A collar button abscess is such an infection when it is located in the web space of the fingers.

Bacteria cause most of these finger infections. The exception to this is the herpetic whitlow, which is caused by a virus. How the infection starts and is found in a particular location is what makes each specific type of infection unique. Usually some form of trauma is the initial event. This may be a cut, animal bite, or puncture wound.

• Paronychia: The offending bacteria are usually staphylococcal and streptococcal organisms. Rarely, a fungus causes this infection, which usually begins as a hangnail. Often a person will attempt to bite off the piece of nail that is at the corner. This results in an open wound that allows the bacteria found on the skin and the bacteria found in the mouth to infect the wound. The infection can then spread to the surrounding tissue next to the nail and cuticle.
• Felon: This bacterial infection of the finger pad, caused by the same organisms that cause paronychia, is usually the result of a puncture wound. The wound allows the introduction of bacteria deep into the fingertip pad. Because the fingertip has multiple compartments, the infection is contained in this area.
• Herpetic whitlow: The offending viral organism is the herpes simplex virus type I or II. This is the same virus that causes oral or genital herpes infections. People in certain occupations are more at risk for this infection. These include dentists, hygienists, physicians, nurses, or any other person who may have contact with saliva or body fluids that contain the virus. People with oral or genital herpes may also infect their own fingers.
• Cellulitis: The most common causes of this bacterial infection are staphylococcal and streptococcal organisms. This infection is usually the result of an open wound that allows the bacteria to infect the local skin and tissue. The infection can also spread to the hand and fingers by blood carrying the organisms.
• Infectious flexor tenosynovitis: This bacterial infection is usually the result of penetrating trauma that introduces bacteria into the deep structures and tendon sheaths, which allows the spread along the tendon and associated sheath.
• Deep space infection: This bacterial infection is usually the result of a puncture wound or deep cut that introduces the bacteria to the deep tissue. The collar button abscess is associated with the web space between the fingers. The deep structures of the hand create many potential compartments for an infection to invade.

Each of the main finger infections has specific signs and symptoms that make identification unique and can sometimes cause confusion if not properly evaluated.

• Paronychia: The area next to the fingernail will appear red and swollen. A visible collection of pus may be seen under the skin and nail. This fluid may be actually leaking out of the wound. The area will be tender and painful to the touch. The drainage from the area is usually a cloudy white-yellow color.
• Felon: The fingertip is swollen and painful. The swelling usually develops over several days and is located in the pad area of the fingertip. The area will have a throbbing pain and be painful to the touch. The area is usually red, and a visible collection of pus may be seen under the skin. The swollen area may have a portion that feels soft as if it contains fluid. As the swelling continues, the area may become tense or hard to the touch.
• Herpetic whitlow: The fingertip area will be red and tender. A burning or itching sensation may be present in the area. There may be mild swelling, but not as extensive as in the felon. There may be a single or many open wounds in the area affected. These open wounds often occur in clusters after the formation of a small blister-like lesion. The fluid in these lesions is usually clear in appearance but may be slightly cloudy. You may also have a low-grade fever and have swollen and tender lymph nodes in the area.
• Cellulitis: The area will be red and warm to the touch. The area may be slightly swollen and tender. This is usually a superficial infection, so the deep structures should not be involved. The motion of the fingers and hand should not be difficult or painful. If painful or difficult, this may indicate a deep space infection of some type.
• Infectious flexor tenosynovitis: Four major signs often are found with this condition. First is tenderness over the flexor or palm side of the finger. This pain is found over the tendons in the finger. Second is uniform swelling of the finger. Third is pain on extending or straightening of the finger. Fourth, the finger will be held in a slightly flexed or partially bent position. These signs are called Kanavel cardinal signs. All 4 signs may not be present at first or all at once.
• Deep space infections: The deep space infection that arises in the web space of the fingers is also called a collar button abscess. The space between the fingers will be painful and swollen. The area may also be red and warm to the touch. As the abscess becomes larger, the fingers will be slightly spread apart by the increasing pressure. The central area may have a soft spot that represents a collection of pus under the skin.

The key to preventing disability and possible loss of the finger is early and appropriate treatment. If any signs and symptoms are present, you should contact your doctor at once.

If you have signs or symptoms of a felon, cellulitis, infectious flexor tenosynovitis, or deep space infection, you should seek emergency care at once.

The correct diagnosis will start with a detailed history and physical exam. People who have a localized infection will be treated differently than someone with a severe infection. Coexisting problems such as diabetes or blood vessel disorders of the arms and legs will complicate the infection and may change the degree of treatment. 

• Important information that your doctor will need to know will include the following:
  • How did the injury or infection start?
  • When did this first occur or begin?
  • Where did it occur? Home? Work? In water? In dirt? From an animal or human bite?
  • Is it possible that a foreign body is in the wound?
  • What have you done to care for this before seeing your doctor?
  • When was your last tetanus shot?
  • Any previous injuries to the area?
  • Any other medical problems that you may have not mentioned?

• Specific information may help pinpoint the type of finger infection:
  • Paronychia: A history of nail biting may aid the diagnosis.
  • Felon: A history of a puncture wound or cut will aid the diagnosis. This would include a plant thorn. The doctor may obtain an x-ray to look for involvement of the bone or possible foreign body.
  • Herpetic whitlow: A history of contact with body fluids that may contain the herpes virus will aid the diagnosis. The diagnosis can often be made from the history and the appearance of the lesions. The presence of a clear fluid from the wounds may indicate a viral infection rather than a bacterial infection. A sample of the fluid may be analyzed by a Tzank smear, which will identify certain cells, indicating a viral cause.
  • Cellulitis: The doctor will need to consider other causes that may look similar such as gout, various rashes, insect sting, burns, or blood clot before the final diagnosis is made. An X-ray may be obtained to look for a foreign body or gas formation that would indicate a type of serious cellulitis.
  • Infectious flexor tenosynovitis: A history of a puncture wound or cut will aid the diagnosis. The presence of the 4 Kanavel cardinal signs is a strong diagnostic aid. A recent sexually transmitted disease may indicate a type of gonorrhea-related infection, which may resemble infectious flexor tenosynovitis.
  • Deep space infections: A history of puncture wound or other wound may aid the diagnosis. The finding of swelling between the fingers with a slow spreading of the involved fingers will help identify a collar button abscess.

Because finger infections have the potential to become severe, home care is limited. A very minor paronychia may be managed at home if you have no other complicating medical illness, such as diabetes. All of the other infections require urgent evaluation and treatment by a doctor. Because delay in treatment may result in disability or loss of the finger, you should not hesitate to obtain medical care.

A small, simple paronychia may respond to frequent warm water soaks and elevation of the hand. However, if no improvement is noticed in 1–2 days, you should see your doctor at once.

The mainstay of treatment for finger infections is antibiotics and proper wound care. This can range from a simple incision and drainage of the wound to an extensive surgical exploration of the wound to remove as much infected material as possible.

Some of the infections can be treated in a doctor’s office or clinic, but several will require inpatient treatment and IV antibiotics. Because the organisms that cause these infections are similar, many of the same types of antibiotics may be used.

• Paronychia: Often the wound may be treated with wound care alone. If a collection of pus is present, it will need to be drained. This may be done in several different ways. Commonly a scalpel is used to make a simple incision over the collection of pus to allow drainage. Or the scalpel may be inserted along the edge of the nail to allow drainage. If the infection is large, a part of the nail may be removed. If this procedure is required, the doctor will inject a local anesthetic at the base of the finger that will provide for a pain-free procedure. Most often, you will be placed on an oral antibiotic. You will then be instructed how to take care of the wound at home. (See paronychia.)
• Felon: Often, incision and drainage is required because the infection develops within the multiple compartments of the fingertip pad. Usually an incision will be made on one or both sides of the fingertip. The doctor will then insert an instrument into the wound and break up the compartments to aid in the drainage. Sometimes, a piece of rubber tubing or gauze will be placed into the wound to aid the initial drainage. The wound may also be flushed out with a sterile solution to remove as much debris as possible. These infections will require antibiotics. The wound will then require specific home care as prescribed by your doctor.
• Herpetic whitlow: Antiviral drugs such as acyclovir (Zovirax) may shorten the duration of illness. Pain medication is often needed. The wound must be properly protected to prevent a secondary bacterial infection and to prevent you from infecting other sites on your body or other people. Incision and drainage is not proper and, if done, may actually delay healing.
• Cellulitis: This infection is superficial, and oral antibiotics are usually sufficient. If the area is extensive or your immune system is weakened, then you may be treated in the hospital with IV antibiotics.
• Infectious flexor tenosynovitis: This is a surgical emergency and will require rapid treatment, hospital admission, and early treatment with IV antibiotics. Usually, the area will need to be surgically opened and all debris and infected material removed. Because of the intricate nature of the fingers and hands, a hand surgeon will usually perform this procedure. After surgery, several days of IV antibiotics will be required followed by a course of oral antibiotics.

• Deep space infections: Much like flexor infectious tenosynovitis, this can require emergency care. If the infection is mild, then only oral antibiotics may be needed. If more severe, a hand surgeon should evaluate the wound and IV antibiotics begun. Often these wounds will require incision and drainage followed by a course of antibiotics.

You need to understand the doctor’s instructions completely and ask any questions you have in order to thoroughly understand your care at home.

• If you have been prescribed antibiotics for a finger infection, you must follow the directions and take them for the prescribed time period.
• Often, your doctor will instruct you to keep your hand elevated to prevent swelling. This is important and needs to be done both during the day and night. By placing pillows next to you while sleeping, your hand can remain elevated.
• Wound care will often need to be continued at home. This may include daily warm water soaks, dressing changes, and application of antibiotic ointment. The different types of wound care are extensive. Your doctor should explain in detail.
• The finger or hand may be placed in a splint. This provides both immobilization and protection. It will be important to follow the instructions regarding the care of the splint. You will need to protect and properly care for the splint. You should closely monitor the finger or hand to watch for complications such as swelling or infection under the splint.
• Often, you will be asked to return to the doctor’s office in 24-48 hours. This may be necessary to remove packing or change a dressing. It is very important that you have close follow-up care to monitor the progress or identify any further problems.

Common sense safety practices will help prevent many of the finger wounds that become a problem. Simple things such as wearing protective work gloves may prevent injury. Wearing latex or vinyl gloves is mandatory if possible exposure to bodily fluids is expected. Avoid chewing on your nails, and wash your hands as needed. Seek early medical attention as soon as you think an infection is present.

If the infections are treated early and properly, the prognosis for full recovery is good. However, if treatment is delayed, or if the infection is severe, the prognosis is not as good.

• With the infections that involve deep structures such as infectious flexor tenosynovitis, even with the best care, the outcome may be less than desirable. Loss of function, loss of sensation, disfigurement, or even loss of the finger is possible.
• Your doctor will need to evaluate each case individually and present the likely outcome based on the findings.

See the following for related finger injuries:

• Broken finger
• Nail injuries
• Subungual hematoma (smashed fingernail, blood under the nail)
• Skier’s thumb (jammed thumb usually in a fall, fall on an outstretched hand)
• Dislocated finger
• Mallet finger (jammed finger, painful tendon injury, common sports injury)
• Onychomycosis (fungal infection of the fingernail or toenail)

Media file 1: Flexor tendon sheaths and radial and ulnar bursae. Image courtesy of Randle L Likes, DO.
 

Media type: Illustration

Media file 2: A herpetic whitlow. Image courtesy of Glen Vaughn, MD.

Media type: Photo

Media file 3: A moderate paronychia. Swelling and redness around the edge of the nail is caused by a large pus collection under the skin. Image courtesy of Christina L Kukula, DO.

Media type: Photo

Media file 4: Drainage of pus from a paronychia. Image courtesy of Glen Vaughn, MD.

Media type: Photo

Media file 5: A paronychia can progress to a felon if left untreated. Image courtesy of A paronychia can progress to a felon if left untreated. Image courtesy of Glen Vaughn, MD.

Media type: Photo

Media file 6: Anatomy of the fingernail. Top – The normal fingernail. Bottom – Nail bed laceration with subungual hematoma.

Media type: Image
 

paronychia, hangnail, onychia lateralis, onychia periungualis, felon, whitlow, herpetic whitlow, cellulitis, infectious flexor tenosynovitis, pyogenic flexor tenosynovitis, flexor tendosynovitis, tendosynovitis, deep space infections, collar button abscess, finger injury, finger infection, onychomycosis

Top Picks

The finger is swollen and blue: what to do

Health

Photo

buritora / Adobe Stock

What to do if the finger is swollen and blue: identifying the cause

If there is swelling, bruising, or redness, it is necessary to identify the cause of the damage. This is important, as improper treatment can aggravate the situation.

Similar symptoms may indicate:

• bruises, fractures or other injuries

• infection of an open wound

• inflammatory process

• consequence of general edema

• overexertion from monotonous activities 3

Each case requires a special approach to treatment

Finger swelling on the hand: what to do in First priority

After finding out the cause, you can take measures to eliminate the tumor:

• In case of a fracture, you should immediately consult a doctor. Before arriving at a medical facility, you can build a splint from a pen, ruler, or other improvised means, firmly fixing broken bones. The main thing is that the dimensions of the tire do not exceed the length of the finger.

• If the tumor is due to the accumulation of pus in the wound, it is necessary to carry out disinfection. Hydrogen peroxide, a hot solution of salt or soda, grated potato lotion and other means are suitable for this. After cleaning, the wound must be lubricated with streptocide and bandaged. Repeat the procedure as needed.

• When the finger is swollen due to joint inflammation, heparin based ointments should be used. You can also use folk recipes: decoctions of chamomile, calendula, a mixture of honey and flour. Such lotions relieve swelling and reduce pain.

It should be remembered that by eliminating the symptom, you do not get rid of the disease ( read also: Reasons why the little finger on the left and right hand goes numb).

If the swelling occurs for no apparent reason, you should seek medical help

My finger is swollen due to overexertion, what should I do?

Sometimes a swelling on the finger can appear from overexertion. In this case, it is necessary to give the joint and muscles a rest, apply a cold compress for 20 minutes and ensure the outflow of blood by raising the arm up ( see also: Why does the thumb on the right hand go numb: causes and treatment).

If the work is related to the manual performance of the same type of actions, it is necessary to regularly do recreational exercises

A swelling on a finger can be a symptom of injury or a consequence of fatigue. Once the cause is determined, treatment can begin.

– Problems with the fingers and hand can occur due to constant work at the computer. Inconvenient hand placement while working with a mouse and keyboard greatly increases the likelihood of developing carpal tunnel syndrome. This is a common pathology in which the median nerve is pinched, leading to swelling of the tendon or ligament and pain in the hand. If nothing is done about this problem, then soon the nerve will atrophy, which will lead to loss of sensation in the fingers.

The syndrome has several signs that first appear only at work, when the hand is tense, and then in a calm, relaxed state. This is numbness of the fingers, pain, tingling, a feeling of weakness in the hand, “goosebumps”. Later, muscles are affected, the functioning of which is determined by the median nerve, and there is weakness in the fingers and even motor disturbances in them.

What to do: Make sure your workplace is comfortable. Do special exercises: join your palms, interlace your fingers and squeeze and unclench them, taking them as far as possible to the side.

doctor-therapist “SM-Clinic”, Ph.D.

Today they are reading

Margot Robbie stepped onto the red carpet in an extreme mini — no one can take their eyes off her feet

One-click test: choose a TARO card and find out what awaits you in your career and love from June 19 to 26

Is she exactly 77 years old? Eternally young Goldie Hawn at a social event amazed everyone with her appearance

Rita Ora was secretly filmed on the beach – do not show married men

“Hairy legs”: Volochkova put on a mini, but she had not yet prepared for the summer – fans ridiculed the star

Inflamed finger abscesses from a hangnail and swollen skin around

August 24, 2022 3:36

Everyone gets hangnails from time to time. This is quite unpleasant, because with them the hands look unkempt. However, this is still half the trouble. The problem becomes much more serious if an abscess forms at the site of protruding dry skin. What to do in such cases? How to relieve pain and is it possible to prevent suppuration? First you need to understand why the finger breaks.

Causing burrs

Dry skin clings to clothing, hair, causing discomfort and pain. In impatience, many pull out the burr with their hands or even tear it off with their teeth. At the place of separation, an even larger burr and a wound are formed. Antiseptic treatment, and sometimes soap, is forgotten. An infection gets into a fresh wound, which causes pus to form. This is the most common cause of an abscess.

It happens that the skin is not torn off, but an abscess still forms, the finger is swollen. This is due to reduced immunity. When the body is weakened, suppuration can occur with any violation of the integrity of the skin and contact of the damaged area with dirt.

The third reason may be the use of household chemicals without gloves. If detergents get into the wound, they “corrode” the edges, increasing the area of ​​\u200b\u200bdamage. When microbes enter, an abscess appears.

Another common cause of painful hangnails is nail biting.

What to do if a burr hurts your finger

If the wound does not fester, steam your finger. To do this, pour warm water into a bowl, add a teaspoon of salt and one drop of iodine. Salt with iodine can be replaced with a few drops of tea tree oil or a couple of potassium permanganate crystals.

Disinfect nail scissors or nippers with alcohol or cologne and use them to cut off the protruding edges of the skin. Treat the painful area with hydrogen peroxide, chlorhexidine or the same alcohol. Bandage your finger.

Aloe is popular among folk remedies. It is necessary to cut off a thin slice of the pulp of the leaf and attach it to the treated area (after the bath and trimming the skin). Next, also bandage. The plant draws out pus and accelerates skin regeneration.

What to do if your finger hurts

In case of an abscess, clean the wound from pus:

• Steam your finger well in a bath with salt and iodine. If there is an outlet for the pus, apply light pressure to the swollen area. A liquid discharge will begin to come out of the purulent sac.
• Replace water. Repeat the manipulations again.
• Treat the wound.
• Bandage your finger.
• Treat the area daily with an antiseptic and change the dressing.

If there is no outlet for pus, do not pick or pierce the skin. After the bath, apply ichthyol ointment or Vishnevsky ointment. Apply a sterile dressing. In advanced cases, a single compress may not be enough. Repeat the steps two or three times.

When all methods have been tried and the swelling and pain persist, see a doctor. Don’t wait for a free entry. With acute pain, the surgeon will see you without a queue.