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Herpetic Whitlow

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2. Whitlow (staphylococcal and herpetic)

Whitlow (staphylococcal and herpetic) Whitlow (staphylococcal and herpetic) - NICE CKS Share Whitlow (staphylococcal and herpetic): summary Staphylococcal whitlow (also known as a felon) is a closed-space infection of the distal finger pulp. It presents with a rapid onset of very severe, throbbing pain, with redness and swelling of the distal pulp of the finger tip. There is usually a history of a penetrating injury or untreated paronychia. Fluctuance and pointing of an abscess may be present (...) . Herpetic whitlow is a herpes simplex infection that typically appears on the distal phalanx of the fingers. It often presents with abrupt onset of oedema, redness, and localized severe tenderness of the infected finger. The pulp space is soft, not tensely swollen, and vesicles are present. There may be a history of current or recent herpetic lesions in the mouth or genitals, or a history of fever or malaise preceding the onset of symptoms. Conditions which may present in a similar way to whitlow

2016 NICE Clinical Knowledge Summaries

3. Herpetic Whitlow

Herpetic Whitlow Herpetic Whitlow Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Herpetic Whitlow Herpetic Whitlow Aka: Herpetic (...) Antiviral agents Herpetic Whitlow is self limited and resolves spontaneously without treatment Indications Recurrent infection Immunocompromised status (risk of disseminated HSV) Consider in first 48 hours to shorten course Agents 400 mg PO tid for 7 days ( ) ( ) XI. Course Resolves spontaneously in 3 to 4 weeks Recurs in 20 to 50% of cases Recurrence is usually more mild than initial event XII. References Cory in Mandell (2000) Infectious Disease, p. 1569-71 Antosia in Marx (2002) Rosen's Emergency

2018 FP Notebook

4. Herpetic Whitlow (Treatment)

Herpetic Whitlow (Treatment) Herpetic Whitlow Treatment & Management: Emergency Department Care Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNzg4MDU2LXRyZWF0bWVudA== processing > Herpetic Whitlow Treatment (...) & Management Updated: Nov 19, 2018 Author: Michael S Omori, MD; Chief Editor: Steven C Dronen, MD, FAAEM Share Email Print Feedback Close Sections Sections Herpetic Whitlow Treatment Emergency Department Care Herpetic whitlow is a self-limited disease. Treatment most often is directed toward symptomatic relief. Acyclovir may be beneficial. Studies of clinical efficacy are limited and treatment suggestions are extrapolated from data regarding response of other HSV infections. In primary infections, topical

2014 eMedicine Emergency Medicine

5. Herpetic Whitlow (Overview)

Herpetic Whitlow (Overview) Herpetic Whitlow: Background, Pathophysiology, Epidemiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNzg4MDU2LW92ZXJ2aWV3 processing > Herpetic Whitlow Updated: Nov 19, 2018 (...) Author: Michael S Omori, MD; Chief Editor: Steven C Dronen, MD, FAAEM Share Email Print Feedback Close Sections Sections Herpetic Whitlow Overview Background Herpetic whitlow is an intensely painful infection of the hand involving 1 or more fingers that typically affects the terminal phalanx. [ ] (HSV-1) is the cause in approximately 60% of cases of herpetic whitlow, and (HSV-2) is the cause in the remaining 40%. Adamson first described herpetic whitlow in 1909, and in 1959, it was noted

2014 eMedicine Emergency Medicine

6. Herpetic Whitlow (Follow-up)

Herpetic Whitlow (Follow-up) Herpetic Whitlow Follow-up: Further Outpatient Care, Inpatient & Outpatient Medications, Deterrence/Prevention Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNzg4MDU2LWZvbGxvd3Vw (...) processing > Herpetic Whitlow Follow-up Updated: Nov 19, 2018 Author: Michael S Omori, MD; Chief Editor: Steven C Dronen, MD, FAAEM Share Email Print Feedback Close Sections Sections Herpetic Whitlow Follow-up Further Outpatient Care Advise routine outpatient follow-up care to ensure resolution of infection and to monitor for evidence of bacterial superinfection. Next: Inpatient & Outpatient Medications Include analgesics in the treatment of herpetic whitlow. Topical acyclovir may be of benefit

2014 eMedicine Emergency Medicine

7. Herpetic Whitlow (Diagnosis)

Herpetic Whitlow (Diagnosis) Herpetic Whitlow: Background, Pathophysiology, Epidemiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNzg4MDU2LW92ZXJ2aWV3 processing > Herpetic Whitlow Updated: Nov 19, 2018 (...) Author: Michael S Omori, MD; Chief Editor: Steven C Dronen, MD, FAAEM Share Email Print Feedback Close Sections Sections Herpetic Whitlow Overview Background Herpetic whitlow is an intensely painful infection of the hand involving 1 or more fingers that typically affects the terminal phalanx. [ ] (HSV-1) is the cause in approximately 60% of cases of herpetic whitlow, and (HSV-2) is the cause in the remaining 40%. Adamson first described herpetic whitlow in 1909, and in 1959, it was noted

2014 eMedicine Emergency Medicine

8. Herpetic whitlow (PubMed)

Herpetic whitlow 22546886 2013 01 17 2018 11 13 1488-2329 184 17 2012 Nov 20 CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne CMAJ Herpetic whitlow. E924 10.1503/cmaj.111741 Hoff Norman-Philipp NP Department of Dermatology, Heinrich-Heine University, Düsseldorf, Germany. norman-philipp.hoff@med.uni-duesseldorf.de Gerber Peter Arne PA eng Case Reports Journal Article 2012 04 30 Canada CMAJ 9711805 0820-3946 0 Antiviral Agents X4HES1O11F Acyclovir AIM IM (...) Acyclovir administration & dosage Antiviral Agents administration & dosage Female Fingers virology Gingivitis virology Herpes Simplex drug therapy Herpesvirus 1, Human Humans Infant Lymphangitis virology Stomatitis, Herpetic drug therapy 2012 5 2 6 0 2012 5 2 6 0 2013 1 18 6 0 ppublish 22546886 cmaj.111741 10.1503/cmaj.111741 PMC3503926 Clin Exp Dermatol. 2005 Sep;30(5):609-10 16045720 Am J Clin Dermatol. 2011 Apr 1;12(2):101-12 21348541 Cochrane Database Syst Rev. 2008;(4):CD006700 18843726 Cutis. 2007

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2012 CMAJ : Canadian Medical Association Journal

9. Herpetic Whitlow

Herpetic Whitlow Herpetic Whitlow Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Herpetic Whitlow Herpetic Whitlow Aka: Herpetic (...) Antiviral agents Herpetic Whitlow is self limited and resolves spontaneously without treatment Indications Recurrent infection Immunocompromised status (risk of disseminated HSV) Consider in first 48 hours to shorten course Agents 400 mg PO tid for 7 days ( ) ( ) XI. Course Resolves spontaneously in 3 to 4 weeks Recurs in 20 to 50% of cases Recurrence is usually more mild than initial event XII. References Cory in Mandell (2000) Infectious Disease, p. 1569-71 Antosia in Marx (2002) Rosen's Emergency

2015 FP Notebook

10. Herpetic whitlows: a medical risk. (PubMed)

Herpetic whitlows: a medical risk. 5134573 1972 03 20 2013 11 21 0007-1447 4 5788 1971 Dec 11 British medical journal Br Med J Herpetic whitlows: a medical risk. 681 Juel-Jensen B E BE eng Clinical Trial Controlled Clinical Trial Journal Article England Br Med J 0372673 0007-1447 0 Antibodies LGP81V5245 Idoxuridine AIM IM Adult Antibodies analysis Fingers Herpes Simplex drug therapy immunology Humans Idoxuridine therapeutic use Physicians 1971 12 11 1971 12 11 0 1 1971 12 11 0 0 ppublish

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1971 British medical journal

11. Herpetic whitlow: a medical risk. (PubMed)

Herpetic whitlow: a medical risk. 5125276 1972 02 14 2018 11 13 0007-1447 4 5785 1971 Nov 20 British medical journal Br Med J Herpetic whitlow: a medical risk. 444 eng Journal Article England Br Med J 0372673 0007-1447 LGP81V5245 Idoxuridine AIM IM Adult Diagnosis, Differential Hand Dermatoses etiology Herpes Simplex diagnosis drug therapy Humans Idoxuridine therapeutic use Nurses Occupational Diseases etiology Physicians Staphylococcal Infections diagnosis 1971 11 20 1971 11 20 0 1 1971 11 20

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1971 British medical journal

12. Identification of ribonucleotide reductase mutation causing temperature-sensitivity of herpes simplex virus isolates from whitlow by deep sequencing (PubMed)

Identification of ribonucleotide reductase mutation causing temperature-sensitivity of herpes simplex virus isolates from whitlow by deep sequencing Herpes simplex virus 2 caused a genital ulcer, and a secondary herpetic whitlow appeared during acyclovir therapy. The secondary and recurrent whitlow isolates were acyclovir-resistant and temperature-sensitive in contrast to a genital isolate. We identified the ribonucleotide reductase mutation responsible for temperature-sensitivity by deep

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2015 Clinical Case Reports

13. Herpetic Whitlow

Herpetic Whitlow Herpetic Whitlow - Musculoskeletal and Connective Tissue Disorders - MSD Manual Professional Edition Brought to you by The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases / / / / OTHER TOPICS IN THIS CHAPTER Test your knowledge Sciatica Which (...) straight with knees and toes pointing toward the wall... SOCIAL MEDIA Add to Any Platform Loading , MD, Perelman School of Medicine at the University of Pennsylvania Click here for Patient Education NOTE: This is the Professional Version. CONSUMERS: Topic Resources Herpetic whitlow is a cutaneous infection of the distal aspect of the finger caused by herpes simplex virus. (See also .) Herpetic Whitlow DR P. MARAZZI/SCIENCE PHOTO LIBRARY Herpetic whitlow may cause intense pain. The digital pulp

2013 Merck Manual (19th Edition)

14. Guidelines for the Management of Genital Herpes in New Zealand

by both HSV-1 and HSV-2 although HSV-1 is less likely to cause recurrent symptoms. • MYTH: Visible genital herpes infection is very typical and does not require diagnostic testing. FACT: Herpetic lesions are often atypical and other conditions may cause genital ulceration; genital lesions should be swabbed and tested for HSV. • MYTH: Herpes simplex virus subtype determination is unnecessary. FACT: As HSV-1 and -2 have different natural histories, it is important to ask for specific typing (so patients (...) -2 represent a new or recently acquired infection. It may be a first clinically recognised episode of a previously unrecognised or asymptomatic infection acquired weeks, months or years previously. The virus is readily inactivated at room temperature and by drying; hence, non-contact forms of spread, for example via fomites (inanimate objects) are considered unlikely. Autoinoculation resulting in spread to different anatomical sites can occur (e.g. orolabial, whitlow), although this is believed

2017 New Zealand Sexual Health Society

15. CRACKCast E050 – Orthopedics – Hand Injuries

finger Herpetic whitlow – HSV infection of the distal finger Pain, pruritis, swelling of finger followed by clear vesicles Avoid I+D – can result in viral dissemination and it can be hard to tell this apart from a felon or paronychia: careful history of risk factors is needed Can consider oral acyclovir, especially in recurrent infections or patients who are immunocompromised Deep space infection of the hand Less common, but can develop infection of the deep spaces of the palm, thenar, or hypothenar

2016 CandiEM

16. Paronychia - acute

features include: Pain and swelling at the base of the fingernail. Localized pain and tenderness of the nail folds. Red, tender, and swollen lateral and/or proximal nail folds often with a visible collection of pus. Conditions that may resemble paronychia include cutaneous candidiasis, acute contact dermatitis, staphylococcal whitlow, finger-tip injuries, insect bites, fungal nail infections, herpetic whitlow, cancer (for example melanoma or squamous cell carcinoma), psoriasis, Reiter syndrome (...) contact dermatitis. Staphylococcal whitlow. For more information, see the CKS topic on . Finger-tip injuries. Insect bites. Fungal nail infections. For more information, see the CKS topic on . Herpetic whitlow — this appears as either a single or a group of blisters. For more information, see the CKS topic on . Cancer (for example melanoma, Bowen disease or squamous cell carcinoma). Psoriasis. Reiter syndrome. Dyshidrotic eczema (pompholyx). Pemphigus vulgaris. Foreign body. Basis for recommendation

2017 NICE Clinical Knowledge Summaries

17. Herpes simplex - genital

30,658 case of genital herpes simplex diagnosed in sexual health clinics — 41% were in those aged 15–24 years. HSV transmission is by direct contact with an infected person who is shedding virus from secretions on oral, genital, or anal mucosal surfaces. Genital herpes can also be acquired from contact with lesions at other anatomical sites, such as the mouth, eyes, and other non-mucosal surfaces (such as herpetic whitlow on fingers or skin lesions). Most genital herpes infections are acquired sub (...) be acquired from contact with lesions at other anatomical sites, such as the eyes, and other non-mucosal surfaces (such as herpetic whitlow on fingers or skin lesions). Transmission is most likely to occur when lesions are present (for example vesicles, or ulcers), however, it may also occur when the virus is shed asymptomatically. Most HSV infections are transmitted by people who are unaware they are infected. At least 80% of people with HSV are unaware they are infected. Asymptomatic viral shedding

2017 NICE Clinical Knowledge Summaries

19. Rash Week! Name That Rash #1

Rash Week! Name That Rash #1 Rash Week! Name That Rash #1 – PEMBlog Search for: Search for: Rash Week! Name That Rash #1 Just look at the rash – then click the box to reveal the diagnosis. That’s it. Nothing fancy. It’s Herpetic Whitlow! Herpetic Whitlow is a condition that often is seen in thumb suckers and is due to herpes simplex virus. The lesions are painful, and should not be confused with abscesses. Attempting an I&D can only make it worse. Treat with pain medicines and antivirals

2018 PEM Blog

20. Herpes simplex - oral

age 6 months onwards. This CKS topic covers the management of oral herpes simplex including oral herpes labialis (cold sores) and gingivostomatitis. This CKS topic does not cover herpetic whitlow, eczema herpeticum, or other herpes infections such as herpes zoster virus. There are separate CKS topics on , , , , , and . The target audience for this CKS topic is healthcare professionals working within the NHS in the UK, and providing first contact or primary healthcare. How up-to-date is this topic (...) virus (HSV) infection is a mild, self-limiting illness, but it can cause severe or life-threatening complications, particularly in immunocompromised people. Possible complications include: Dehydration — from poor oral intake due to painful swallowing, and fever (especially in young children with primary herpes gingivostomatitis). Herpetic whitlow (from autoinoculation) — vesicular lesions on the hands or digits, for example in thumb-sucking children. For more information, see the CKS topic

2016 NICE Clinical Knowledge Summaries

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