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Self-Assessment Questions

Orthopaedic Surgery

Answer 4
  1. Bacterial paronychia. The location (perionychium) and rapid onset (4 days) of this patientıs infection is consistent with an acute paronychia. Generally, bacterial infections are more acute, and fungal infections are chronic. Thumb-sucking is a common cause for such infections. This presentation is unlikely to be a felon because felons cause severe pain and develop in the pads of the fingers and near the distal interphalangeal joints. Herpetic whitlow, caused by a herpes simplex virus, causes pain and swelling and leaves small clear vesicles or cysts. A tumor is unlikely because of the location of infection and age of the child.5

     Jebson PJ. Infections of the fingertip. Paronychias and felons. Hand Clin 1998;14:547-55.

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