Human bite wounds contain  aerobic and anaerobic bacteria

Aerobic pathogens:

• Staphylococcus aureus

• Staphylococcus epidermidis

• Streptococci

Anaerobic pathogens:

• Peptostreptococci​

• Peptococci

• Bacteroides

• Eikenella corrodens

Cat and dog bites are frequently colonized by Pasteurella multocida​

Chronic inflammatory condition resulting in thickening of the cuticle and grooving of the nail

Most commonly seen in middle-aged women

Commonest pathogen is Candida albicans

Effective treatment is difficult and may consist of:

• Marsupialisation of the eponychium​

• Nail removal followed by application of antifunal cream to the nailbed

Infection of the finger pulp

Usually occurs as a result of a penetrating wound

The resultant abscess results in pain and erythema

The collection should be drained over the point of maximum fluctuance

Untreated infections may result in:

• Osteomyelitis​

• Septic arthritis

• Flexor sheath infection

• Tender scars on the finger pulp

Superficial infection of the fingertip

Caused by herpes simplex virus

Common in health workers who are exposed to the virus

Presents with pain, swelling, erythema

Small clear vesicles are present at the early stages of the infection

Conservative treatment

Typically resolves within 3 weeks

Surgical drainage not indicated as this can cause bacterial superinfection

Severe infection usually resulting from penetrating injury to the flexor sheath

Also known as flexor sheath infection

Kanavel's four cardinal signs

• Fusiform swelling of the finger​

• Semi-flexed finger position

• Tenderness over the flexor sheath

• Pain on passive extension

Treated by drainage and irrigation of the flexor sheath​

Open technique - decompression of finger along its length

Closed technique - sheath is copiously irrigated throguh limited proximal and distal incisions

Flexor sheath infections of the index finger may rupture into the thenar space

Flexor sheath infections of the middle and ring fingers may rupture into the mid-palmar space

Flexor sheath infections of the thumb and little finger can drain through the radial and ulnar mursae into the space of Parona - also known as a horseshoe abscess