Hand Infection

Description

• Hand infections are commonly seen in the ED
• The range of pathology is broad and may include acute and chronic conditions

• Serious hand infections are potential liability issues and must be handled with extreme caution
• Maintain a high level of suspicion for clenched fist injuries
• Referral to hand surgeon is almost always indicated

Etiology

• Bacterial infection of the hand is associated with skin pathogens:
  • Staphylococcus or Streptococcus spp
  • History of a puncture wound
• Anaerobes are identified in 75% of paronychia in children owing to thumb sucking and nail biting
• Chronic paronychia may be caused by Candida albicans
• Herpetic whitlow is caused by type 1–2 herpes simplex virus
• Clenched fist injuries involve a variety of pathogens, including anaerobic Streptococcus and Eikenella spp