What is the diagnosis and treatment of a finger felon (infection of the fingertip pad)?

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Last updated: May 1, 2025View editorial policy

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Differential Diagnosis for Finger Felon

Single Most Likely Diagnosis

  • Acute Paronychia: This is the most likely diagnosis for a finger felon, which is an infection of the fingertip pad. The infection is usually caused by bacteria, such as Staphylococcus aureus, and can result from a puncture wound or other trauma to the fingertip.

Other Likely Diagnoses

  • Herpetic Whitlow: A viral infection caused by herpes simplex virus, which can cause similar symptoms to a felon, including pain, swelling, and vesicle formation on the fingertip.
  • Fungal Infection: A fungal infection, such as candidiasis or dermatophytosis, can also cause symptoms similar to a felon, especially in individuals with compromised immune systems.
  • Cellulitis: A bacterial infection of the skin and subcutaneous tissue, which can cause redness, swelling, and pain in the affected area, including the fingertip.

Do Not Miss Diagnoses

  • Osteomyelitis: A bone infection that can occur if the felon is left untreated or if the infection spreads to the bone. This diagnosis is critical to identify, as osteomyelitis can lead to serious complications, including bone destruction and sepsis.
  • Septic Arthritis: A joint infection that can occur if the felon is left untreated or if the infection spreads to the joint. This diagnosis is critical to identify, as septic arthritis can lead to serious complications, including joint destruction and sepsis.
  • Gangrene: A condition that occurs when the blood supply to the affected area is compromised, leading to tissue death. This diagnosis is critical to identify, as gangrene can lead to serious complications, including amputation.

Rare Diagnoses

  • Tuberculous Tenosynovitis: A rare infection caused by Mycobacterium tuberculosis, which can cause symptoms similar to a felon, including pain, swelling, and limited range of motion in the affected finger.
  • Sporotrichosis: A rare fungal infection caused by Sporothrix schenckii, which can cause symptoms similar to a felon, including pain, swelling, and ulceration on the fingertip.
  • Nocardial Infection: A rare bacterial infection caused by Nocardia species, which can cause symptoms similar to a felon, including pain, swelling, and abscess formation on the fingertip.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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