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Question
30 year old female presents with a painful finger for 1 week. Finger exam showed the following. What is the diagnosis ?
Answer
Herpetic whitlow
- It is caused by either HSV 1 or 2.
- Infection is usually transmitted by direct unprotected contact.
- Healthcare workers are at risk of contracting the infection if appropriate preventative measures were not taken when dealing with patients who have the infection.
- Diagnosis is mainly clinical. Tzank smears can be done to confirm the diagnosis if in doubt.
- Treatment with Acyclovir is thought to shorten the duration of the infection and prevent recurrence if started within 72 hours of beginning of symptoms.
- Incision of the vesicular lesion is contraindicated and can cause severe bacterial superinfection.
References
McDonald, Lucas S., et al. "Hand infections." The Journal of hand surgery36.8 (2011): 1403-1412.