From the Guidelines
Yes, a felon can be associated with subungual purulence, as the infection in the pulp space can track beneath the nail, resulting in pus collection under the nail. A felon is a painful infection of the pulp space of the fingertip, typically caused by Staphylococcus aureus. The connection between felons and subungual purulence occurs because the infection can extend beneath the nail, creating pus collections in this area as the infection progresses.
Key Points to Consider
- Treatment typically involves prompt incision and drainage, along with antibiotics such as dicloxacillin or cephalexin for 7-10 days, as suggested by general medical knowledge and not explicitly stated in the provided evidence 1.
- For MRSA concerns, consider trimethoprim-sulfamethoxazole or clindamycin, although the provided evidence does not specifically address MRSA treatment in the context of felons.
- The procedure requires a digital block for anesthesia, followed by incision over the point of maximal tenderness, drainage of pus, and irrigation with normal saline.
- If subungual involvement is present, partial nail removal may be necessary to adequately drain the infection, as implied by the treatment of grade 2 and 3 paronychia and onycholysis in the provided evidence 1.
Important Considerations
- Without proper treatment, complications can include osteomyelitis, septic arthritis, or permanent damage to the fingertip.
- The provided evidence does not directly address the treatment of felons, but the principles of managing infections and preventing further complications can be applied to this condition.
- It is essential to prioritize morbidity, mortality, and quality of life when managing felons and subungual purulence, ensuring prompt and effective treatment to prevent long-term damage.
From the Research
Association between Felon and Subungual Purulence
- Felon is a type of infection that occurs on the fingertip pad, and it can be associated with subungual purulence, which is the accumulation of pus under the nail 2.
- A study published in 2016 found that felon and paronychia (another type of hand infection) often present with abscesses, which require surgical treatment 2.
- The study included 46 patients with paronychia, felon, or both, and found that surgical excision without antibiotic coverage led to excellent results with rare recurrence 2.
- However, it is not explicitly stated in the study whether subungual purulence is a common complication of felon, but it can be inferred that felon can lead to purulent infections, which may include subungual purulence 2.
- Another study published in 2018 discussed the diagnosis and treatment of skin and soft tissue infections, including purulent cellulitis and abscesses, but did not specifically mention the association between felon and subungual purulence 3.
- The 2018 study emphasized the importance of incision and drainage for abscesses, which may be relevant to the treatment of felon and subungual purulence 3.