Hand Infections

Hand infections can affect several components of the hand like the nails, skin, tendons, tendon sheaths and the spaces within the hand. Infections of the hand may lead to severe problems which can persist even after the infection has been treated. These problems may include stiffness, loss of strength, and loss of tissues like skin, nerve and bone. There are different types of hand infections, including:

• Paronychia – This is also called a nail fold infection that results in the accumulation of pus, which may be caused by a hangnail, nail-biting and frequent exposure to moisture. The condition may also be caused by dry, cracked skin as a result of dry weather or contact with detergents.
• Herpetic whitlow – This is a herpes simplex infection that occurs on the fingertip tissues which may mimic paronychia.
• Felon – This is a hand infection which appears as an abscess on the fingertip pad.
• Pyogenic flexor tenosynovitis – The flexor tendon sheath is the closed space in the hand which contains the flexor tendon and synovial fluid. This hand infection occurs due to bacteria entering the flexor tendon sheath due to direct trauma or rarely as bloodborne pathogens.
• Cellulitis and fasciitis – This is a soft tissue infection which may range from cellulitis to aggressive necrotising fasciitis, which can result in a severe life-threatening infection that requires urgent surgery. Cellulitis is much more common than necrotising fasciitis and is usually successfully treated with antibiotics alone.
• Webspace abscess – This is an infection in the webspace, which is the area between the base of the fingers. It is caused by a bacterial infection and results in the formation of pus, which needs to be drained to treat the infection.

Any part of the hand can get infected, and this requires urgent treatment. Symptoms of a hand infection include pain, swelling, redness and warmth. Prof McGuire specialises in diagnosing and treating hand infections. Early infections usually respond well to antibiotics. If not treated early, an infection may develop into an abscess, which is then resistant to antibiotics as it contains pus. If this occurs, the pus will need to be drained.

Infections can also quickly spread to other parts of the hand and up the forearm, particularly in people who are diabetic or immunocompromised. If you think you have a hand infection, it is vital you see a doctor as soon as possible.