Differential Diagnosis for Multiple Pyogenic Finger Lesions
- Single most likely diagnosis
- Staphylococcal or Streptococcal Infection: This is the most common cause of pyogenic finger lesions, often resulting from direct inoculation of bacteria into the skin through minor trauma. The presence of multiple lesions could indicate a more severe infection or poor immune response.
- Other Likely diagnoses
- Folliculitis: An infection of the hair follicles, which can be caused by bacteria such as Staphylococcus aureus. It presents as small, pus-filled bumps and can occur on the fingers.
- Paronychia: An infection of the skin around the nail, often caused by Staphylococcus aureus or Streptococcus species. It can present as a single or multiple lesions and is usually associated with nail biting, finger sucking, or exposure to detergents.
- Herpetic Whitlow: A viral infection caused by the herpes simplex virus, leading to painful, fluid-filled blisters on the fingers. Although not typically described as pyogenic, the initial stages can mimic bacterial infections.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Gonococcal Infection: Although less common, gonococcal infections can cause skin lesions, including on the fingers, especially in individuals with a history of sexually transmitted infections. Missing this diagnosis could lead to severe consequences, including disseminated gonococcal infection.
- Sporotrichosis: A fungal infection caused by Sporothrix schenckii, typically acquired through skin inoculation from a thorn prick or similar minor trauma. It can cause nodular lesions along the lymphatic pathways of the infected limb, including the fingers.
- Rare diagnoses
- Erysipeloid: A bacterial infection caused by Erysipelothrix rhusiopathiae, usually acquired through contact with infected animals or contaminated animal products. It presents as a well-demarcated, red, and painful lesion, typically on the hand or finger.
- Atypical Mycobacterial Infections: Certain mycobacteria, such as Mycobacterium marinum, can cause skin infections, including lesions on the fingers, especially after exposure to contaminated water. These infections can be challenging to diagnose and treat.