Hand Infections

The hand becomes infected more frequently as it is one of the most commonly injured parts of our body. 

Untreated Hand Infections

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 will persist even after the infection resolves. Therefore, prompt treatment of hand infections is important.

Common Infections of the Hand

Infections of the hand include:

Paronychia

Paronychia is an infection of the nail fold or cuticle area present around the fingernail. It may be an acute or chronic infection. 

Acute paronychia is a bacterial infection and 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 and if pus forms, it needs to be drained. 

Chronic paronychia is a result of fungal infection and it causes milder 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 steroid and antifungal ointments. 

Felon

Felon is a serious infection of the fatty tissues of the fingertips and results in throbbing pain. It is caused due to direct entry of bacteria during a penetrating injury or by the spread of infection from untreated paronychia. 

If there is an abscess, surgical drainage is performed, following which antibiotics will be prescribed.

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 patient’s saliva that may carry the virus. Herpetic whitlow presents as small, swollen, painful blisters. 

Conservative treatment for herpetic whitlow involves the application of a dry gauze dressing to the affected finger to avoid the spread of infection. 

Septic arthritis/osteomyelitis

Septic arthritis is a severe infection of the joint caused by a wound or draining cyst. The bacterial infection may cause destruction of the joint by eroding away the joint cartilage. 

Surgical drainage should be performed 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 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 bites 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 given initial treatment and left open to allow the infection to drain out. 

Surgical trimming of infected or crushed tissue may be done.