Hand Infection



  • 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


  • 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

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