Felon is caused by bacteria that has passed through a break in the skin. Common breaks on fingertip include a splinter, a paper cut, or needle puncture.
Once the bacteria is in the skin it can grow. The immune system sends blood cells to attack the bacteria. The dead bacteria and immune cells build up in the area. This build up is known as pus.
The swelling and pus can create a lot of pressure in the small area. The pressure can slow or stop blood flow to the area. This will cause extra damage to nearby tissue.
Factors that may increase your chances of a felon include:
A weakened immune system
Medications that affect how the immune system works
Repetitive finger sticks, common with blood tests or blood glucose checks
Occupations or sports that carry a high risk of hand injury
A felon causes:
Rapid, throbbing pain
Swelling in the soft tissue of the fingertip
Redness and warmth (not always present)
You will be asked about your symptoms and health history. A physical exam will be done. The doctor can diagnose a felon based on appearance. Some tests may be done to see if there is tissue damage.
A sample of fluid from the area may be taken. It will show the exact type of bacteria that is causing the infection. It may be needed for severe infections or those that don’t respond to treatment.
Treatment will be started right away with antibiotics. They are often effective for most bacterial infections. Antibiotics may be given through an IV or by mouth. They type of antibiotic may be changed if the infection does not respond as expected.
Surgery may be needed if there is severe swelling or tissue damage. Surgical steps may include:
Opening skin over the area—will allow fluids and pus to drain out
Cellulitis infection—finger felon. Sports Injury Clinic website. Available at: http://www.sportsinjuryclinic.net/sport-injuries/wrist-pain/cellulitis-infection-finger. Accessed March 16, 2018.
Clark DC. Common acute hand injuries. Am Fam Physician. 2003;68(11):2167-2176.
Felon. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/hand-disorders/felon. Updated November 2016. Accessed March 16, 2018.
Rigopoulos N, Dailiana ZH, et al. Closed-space hand infections: diagnostic and treatment considerations. Orthop Rev (Pavia). 2012;4(2):e19.
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