Chapter 34 - Infections of the Hand Flashcards
most common bacteria in paronychia
staphylococcus aureus
most common bacteria in chronic paronychia
staph, but candida albicans is often cultured from these
pathophysiology of felon
fingertip pulp infection usually caused by penetrating injury
usual pathogen for felon
staph aureus
Herpetic whitlow definition
common in childre, dental workers, respiratory therapists
HSV virus
presentation of herpetic whitlow
mild erythema, swelling and clear vesicles with intense burning pain initially - then coalece into one big bullae over 14 days
Treatment of herpetic whitlow
acyclovir
debridement is contraindicated due to severe complications of bacterial superinfection (reports of death)
FTS knavel signs
fusiform swelling
flexed position
pain with digit extension
pain with palpation of the sheath
pathologic bacteria in FTS
staph, but can have gram negs and mixed flora infections
horseshoe abscess
small finger and thumb flexor bursae connect at the wrist - can get connection of pus
Chronic FTS (chronic swelling and pain over the flexor tendons) should raise suspicion for what bacteria?
mycobacteria
Look for remote marine water trauma, immunocompromised status
send for acid fast bacilli
Pathophysiology of septic arthritis
bactericidal enzymes and immune complexes leading to cartilage proteoglycan destruction
For PIP septic arthritis what is the preferred incision?
mid-axial (eg along radial or ulnar border) to prevent damage to the central slip
most common bacteria in fight bites
Staph aureus, then strptococcus
**Eikenella and other gram negs are commonly found as well
epidemiology of dog v cat bites
dog bites more common
cats have sharper teeth that are more likely to penetrate deep structures or intraarticular
dog is more likely to cause greater overall soft tissue injury (crush) but allow more drainage
