Monday, July 19, 2021

Hand Infections

emDocs - July 19, 2021 - By Sarah Brubaker / Reviewed by Alex Koyfman and Brit Long
Clinical Pearls
  1. Use ultrasound and your physical exam to distinguish between superficial and deep-space infection. If you have high concern for deep-space infection, consult your orthopedist, regardless of lab values.
  2. If you discharge the patient, remember to consider MRSA coverage, soft-tissue immobilization, and 48-hour re-check. If you performed an I&D, regular warm water soaks will probably be useful to ensure proper continued drainage.
  3. Don’t forget to ask about recent exposures and injuries; human bites, animal bites, and other zoonotic exposures require specific antibiotic coverage.
  4. If there is an associated wound, check the patient’s tetanus immunization status, and give the patient a tetanus booster if it was not updated in the last 5 years.
  5. Make sure a paronychia is NOT herpetic whitlow, because attempting to I&D herpetic whitlow will only make matters worse