Hand Infections

Hands become infected more frequently as it is one of the commonly injured parts of our body. Hand infections, if left untreated or treated improperly can cause disabilities such as stiffness, contracture, weakness, and loss of tissues (skin, nerve and bone) that persist even after the infection resolves. Therefore, prompt treatment of hand infections is important.

Infections of the hand include:

Paronychia

Paronychia is an infection of the nail fold or cuticle area present around the fingernail. Paronychia may be an acute or chronic infection. Acute paronychia is a bacterial infection that causes pain, redness and swelling around the nail. It is caused by superficial trauma that may occur during nail biting or finger sucking. It can be treated with antibiotics. If pus forms, it needs to be drained. Chronic paronychia is a result of a fungal infection and causes symptoms such as mild pain, redness or swelling, with little or no pus. It occurs most commonly in people whose hands are often wet or are immunocompromised. The treatment for chronic paronychia consists of avoiding constant exposure to moisture and application of topical steroids and antifungal ointments.

Felon

Felon is a serious infection of the fatty tissues of the finger tips, which results in throbbing pain. It is caused due to direct entry of bacteria during a penetrating injury or by spread of infection from untreated paronychia. If there is an abscess, surgical drainage is performed following by the administration of antibiotics.

Herpetic whitlow

Herpetic whitlow is a herpes simplex virus infection of the fingers. It is more common in healthcare workers whose hands are exposed to patients' saliva, which may carry the virus. Herpetic whitlow presents small, swollen and painful blisters. Conservative treatment for herpetic whitlow involves the application of a dry gauze dressing to the affected finger to avoid spread of infection.

Septic arthritis/osteomyelitis

Septic arthritis is a severe infection of the joint caused by a wound or a draining cyst. The bacterial infection may cause destruction of the joint by eroding the joint cartilage. Surgical drainage should be done as soon as possible because the condition may get complicated if the infection spreads to the bone, causing osteomyelitis.

Deep space infections

Deep fascial spaces are the potential spaces in between the different structures of the hand. These spaces tend to get infected through penetrating wounds or spread of infection from blood. Deep space infections may occur in the thumb, the palm or in the area between the bases of fingers. Treatment for deep space infections includes antibiotic therapy, pain relieving medications and surgical drainage.

Tendon sheath infection

Tendon sheath infection is the infection of the flexor tendon, which occurs because of a small laceration or penetrating wound on the finger near a joint. It causes severe stiffness of the finger, accompanied by redness, swelling and pain. This condition may also lead to destruction and rupture of the tendon. Therefore, it demands the immediate surgical drainage.

Atypical mycobacterial infections

Atypical mycobacterial infections are tendon sheath infections caused by an atypical mycobacterium. These infections cause stiffness and swelling without much pain and redness. Antibiotic treatment is administered for several months, following which surgical removal of the infected tendon sheath may be performed.

Infections from bite wounds

Infections from animal or human bite are associated with bacteria such as Streptococcus and Staphylococcus, Eikenella corrodens (human bite injuries) and Pasteurella multocida (dog and cat bite injuries). These wounds are treated with initial therapy and left open to allow the infection to drain out. Surgical trimming of infected or crushed tissue may be done.

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