What Do Inflamed And Discolored Swelling On The Index Finger Indicate?

Posted on Thu, 2 Nov 2017

Question: Dr. my 44 year old nephew had a seeming infection in his index finger near where he bites his nails and tears skin. He also felt like he got a bug bite. He also was cleaning the carpet were feces had spilled. The feces had been cleaned and supposedly treated with disinfectant, but not the stains.
His finger started swelling where he bit the skin near the lower left of the nail.
He used hot water and that changed the color of the finger from whitish to some red inflammation. There still was a whitish puss like color near the original problem at the base of the fingernail.
That was Saturday. Today Sunday he tried cold water and added a lot of Silvedane since the swelling and red inflammation; a minor reddish color, moved all the way passed his knuckle toward his hand. The skin is hard to the touch.
A small seepage of possible puss is showing just a pinhead escape, maybe being swept off since he keeps active..This is st the bottom of the finger below the back of the nail.Below the are of original concern.
The pain is really bothering him. He thinks something may be in the wound
Should he continue hot water soaks and silvedane topical treatment again for the infection?

Answered by Dr. Shinas Hussain (1 hour later)

Brief Answer:
Seems like pulp space infection.

Detailed Answer:

Hello,
Thanks for trusting HealthcareMagic

I have gone through your query and I can understand your concerns.
The description you have provided suggestive of pulp space infection aka felon. It is nothing but closed-space infections of the fingertip pulp.

Early treatment is required to prevent complications which can be potentially dangerous. In your case, it has extended to palm and there is pus collection.

Topical ointments are not effective at this stage. Consult a general surgeon and get the abscess drained. Surgeon may put a small incision over the swelling and drain the pus and debris from the lesion. Pus have to be sent for culture study and antibiotics have to be started based on it.

Appropriate follow-up should always be arranged to prevent complications like finger tip osteomyelitis. Check his blood sugar to look for any undetected diabetes.

Wishing you good health
Thanks

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Above answer was peer-reviewed by : Dr. Yogesh D