Summary about Disease
Whitlow is a painful infection of the fingers, typically involving the pulp of the fingertip. It's usually caused by the herpes simplex virus (HSV), leading to herpetic whitlow, or by bacteria, causing bacterial whitlow. It is characterized by redness, swelling, and small blisters or pustules on the affected finger.
Symptoms
Pain and throbbing in the affected finger
Redness and swelling
Small, fluid-filled blisters (vesicles) or pustules
Tenderness to the touch
Fever (less common)
Tingling or burning sensation before blisters appear (especially in herpetic whitlow)
Causes
Herpetic Whitlow: Herpes simplex virus (HSV-1 or HSV-2), often contracted through direct contact with herpes sores (e.g., cold sores or genital herpes) or by autoinoculation (self-infection). Common in healthcare workers, especially those exposed to oral secretions.
Bacterial Whitlow: Bacteria, most commonly Staphylococcus aureus, entering through breaks in the skin, such as cuts, hangnails, or abrasions.
Medicine Used
Herpetic Whitlow:
Antiviral medications: Acyclovir, valacyclovir, or famciclovir (oral or topical).
Pain relievers: Over-the-counter pain medication to alleviate discomfort.
Bacterial Whitlow:
Antibiotics: Oral antibiotics, such as cephalexin or dicloxacillin, are typically prescribed.
Incision and drainage: If an abscess forms, a doctor may need to drain it.
Is Communicable
Yes, whitlow is communicable.
Herpetic whitlow is highly contagious through direct contact with the blisters or the fluid inside them.
Bacterial whitlow can also spread through direct contact, especially if the infected area is draining.
Precautions
Avoid touching or picking at the affected area.
Keep the area clean and dry.
Cover the infected finger with a bandage to prevent spreading the infection.
Wash hands frequently and thoroughly with soap and water.
Avoid sharing personal items, such as towels, with others.
If you have herpetic whitlow, avoid touching your eyes or genital area to prevent spreading the virus.
Healthcare workers with whitlow should avoid direct patient contact until the infection clears.
How long does an outbreak last?
Herpetic Whitlow: Typically lasts 2-4 weeks.
Bacterial Whitlow: With appropriate treatment, it usually resolves within 1-2 weeks.
How is it diagnosed?
Visual Examination: A doctor can often diagnose whitlow based on the appearance of the finger.
Viral Culture or PCR: For herpetic whitlow, a viral culture or PCR test can confirm the presence of the herpes simplex virus.
Bacterial Culture: For bacterial whitlow, a sample of the pus can be cultured to identify the specific bacteria causing the infection.
Timeline of Symptoms
Herpetic Whitlow:
Prodrome (1-2 days): Tingling, burning, or itching sensation on the finger.
Vesicular Stage (4-5 days): Small, painful blisters appear.
Ulcerative Stage (several days): Blisters break open and form shallow ulcers.
Crusting and Healing (1-2 weeks): Ulcers crust over and gradually heal.
Bacterial Whitlow:
Initial Stage (1-3 days): Redness, swelling, and throbbing pain develop.
Progression (days to a week): Pain increases, and pus-filled abscess may form.
Important Considerations
Early diagnosis and treatment are crucial to prevent complications and reduce the duration of the outbreak.
Individuals with weakened immune systems may experience more severe or prolonged infections.
Recurrences of herpetic whitlow are possible.
If pain is severe or if the infection spreads beyond the fingertip, seek immediate medical attention.
In rare cases, bacterial whitlow can lead to more serious infections, such as tenosynovitis (infection of the tendon sheath) or osteomyelitis (bone infection).