|Physical Signs and Symptoms
|Mode of Infection
Emergency Department Care:
Follow up Care
In/Out Patient Medicines
Herpetic whitlow is an infection of the finger by the herpes simplex virus (HSV). Herpetic whitlow is typically caused by HSV-1, the type that generally causes oral herpes. Herpes can infect any site on the skin, but the finger is probably the most common. Children newly infected with oral herpes can spread it to their thumbs during sucking. In adults, it also can be spread from an oral lesion, almost always after a primary (new) infection rather than recurrences.
Health care workers such as dental hygienists frequently develop herpetic whitlow after caring for patients with oral herpes. A person infected with HSV can transmit it to others even if he or she has no active lesions, so you may have contracted it from any one of your patients. This infection is just one more reason to wear gloves with every single patient.
Unlike oral and genital herpes, which the infected person can transmit even when he or she has no visible lesions, herpetic whitlow probably is less likely to spread in the absence of lesions. One is probably contagious as long as one has a wet, open lesion. Since it is only on the finger, it is probably not infectious as long as gloves are worn. Herpetic whitlow can recur, though usually not as often as do oral or genital herpes.
As far as a baby is concerned, herpetic whitlow in the mother is not really a cause to worry too much. It is genital herpes that causes most of the problems for newborns. Women who become infected shortly before delivery and have genital lesions at the time of delivery are most likely to transmit the infection to the baby, although individuals with recurrent herpes lesions also can infect the baby during delivery.
Far less common is infection during pregnancy, long before delivery. Infection of the fetus can result in stillbirth and congenital anomalies. Most of the data on transmission to the fetus involve genital herpes, not oral herpes.
After an incubation period of 2 to 14 days, the patient may experience prodromal symptoms, such as fever and malaise. Common initial symptoms of infection include tingling pain or tenderness in the affected digit, followed by throbbing pain, swelling, and redness. Vesicles, which form over the next week, contain fluid that may be clear, bloody, or cloudy. While these vesicles are present, herpetic whitlow is extremely contagious.
About 2 weeks after vesicles first appear, a crust forms over them. This signals the end of viral shedding.
If untreated, the infection usually resolves in 3 to 4 weeks. Treatment with antiviral medication may speed healing and reduce viral shedding, but some patients never regain full sensitivity or range of motion in the digit.
Herpetic whitlow vesicles are susceptible to secondary bacterial infections. Signs and symptoms of a secondary infection include fever, chills, red streaks the length of the arm, lymphadenopathy, and fatigue.
After healing, about 20% to 50% of the patients experience recurrences, which may be triggered by trauma, febrile illness, disease, or other physiologic changes. The recurrence usually is milder and clears up faster than the original infection.
The health care provider will base her diagnosis on signs and symptoms and confirm it with lab testing Options include isolating the virus from a sample of vesicular fluid, a Tzanck test (a stain histology test), and serum immunoglobulin antibody testing for HSV IgM (to detect acute HSV) and IgG (to detect a history of HSV).
To treat herpetic whitlow, the health care provider will order an oral, topical, or I.V. antiviral medication. These medications accelerate healing, reduce viral shedding and pain, and may help prevent a recurrence. Prescriptions for secondary infection may be given, if indicated. Incision and drainage of vesicles isn’t indicated because this may spread the infection.
|FAQ’s for Herpetic Whitlow
Finger Herpetic Whitlow Picture
Herpes Treatment– A beautiful melange of time-tested resonance homeopathic medicines and homotoxological remedies so as to stimulate the immune system to heal itself following nature’s laws.
Symptoms caused by HSV 1 infection (HSV 1 is known to affect the following areas of the body.)