Paronychia and Whitlow (Nail infection) | Medtick
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Paronychia and Whitlow (Nail infection)

What is it?

An infection of the perionychium that occurs between nail and skin.

  • It can be short term which is normally bacterial or a long term infection which is normally due to a fungal infection.
  • It is common in children due to sucking their thumb.

Diagnosis tests

  • Clinical examination
  • Pus/wound culture and sensitivity
  • Gram stain of pus
  • HSV PCR or viral culture
  • Fungal testing (KOH preparation and fungal culture) – check for fungal nail infection
  • Ultrasound of soft tissue – for deeper bacterial infection or abscess
  • X-ray of the finger – check for a foreign body, bone infection (osteomyelitis), fracture, or deep infection.
  • Complete blood count (CBC/FBC) and CRP
  • Blood glucose/HbA1c testing – if have recurrent infection, check for diabetes
  • Test for herpetic whitlow

Cause

  • Bacteria:
    • Streptococcus aureus
    • Stapphycoccus aureus
    • Pseudomonoas aeruginosa
  • Fungal:
    • Candida albican
  • Viral
  • A hanging nail
  • Sucking the thumb
  • Ingrown nail
  • Aggressive manicuring
  • Finger scratching or picking
  • Injury
  • Nail biting
  • Nail exposure to chemical and/or irritants
  • Weak immune condition
  • Poor circulation to hands and feet

Syndromes

Symptoms

Short term nail infection (bacterial):

  • Hot, red, inflamed and swelling around skin bed to the nail?
  • Pus develops that separates the nail from the skin?

Whitlow (normally bacterial):

  • Swollen, tender, hot skin which is fluid filled around nail and can be very painful and tender when touched?
  • Onset of pain is rapid and can affect entire finger pulp?

Nail changes:

Complications /Information to beware of/General tips:

This condition can lead to:

General tips

  • Soak hand and/or foot affected in water (one may wish to add salt) three to four times daily.
  • Do not share towel, flannels and utensils.
  • Keep finger nail short.
  • Do not scratch skin/pick

Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist) for further advice

Detailed Information

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