Felon


Felon is infection of the fingertip pulp. The fingertip is separated into small closed spaces by vertical septae. Infection can easily spread along these compartments and cause an abscess. S. aureus is the most common agent.

SYMPTOMS/EXAM

DIAGNOSIS

TREATMENT

Felon/
paronychia
TMP/SMX double strength, 1-2 tablets BID PO for 7-10 d. S. aureus (MRSA), S. pyogenes, anaerobes, polymicrobial Antibiotics indicated for infections with associated localized cellulitis, otherwise drainage alone may be sufficient, culture recommended by hand surgeons.
 
Plus/minus cephalexin, 500 mg PO QID for 7–10 d, or dicloxacillin, 500 mg PO QID for 7-10 d.
Consider addition of clindamycin or amoxicillin-clavulanate to TMP/SMX (rather than cephalexin) if anaerobic bacteria are suspected.

COMPLICATIONS