Abstract
IntroductionWhitlow is an infection of a finger or around the fingernails, generally caused by bacterium. However, in rare cases, it may also be caused by the herpes simplex virus. As herpetic whitlow is not seen often, it may go under-recognised or be mistaken for a different kind of infection of the finger. Delayed recognition and/or treatment puts patients at risk of complications ranging from superinfection to herpetic encephalitis.Case presentationA 23-year-old Caucasian man with no medical history was referred by his primary care physician because of erythema and swelling of the little finger of his left hand. The primary care physician had already treated him with the oral antibiotic Augmentin® (amoxicillin-clavulanic acid) and incision of the finger, but this had not resolved his complaints. He had multiple vesicles on the finger, which led to the diagnosis of herpetic whitlow, which we confirmed by polymerase chain reaction testing. All cutaneous abnormalities disappeared after treatment.ConclusionsWhitlow is rarely caused by the herpes simplex virus, but this disease requires a swift recognition and treatment to prevent complications. This case serves to emphasise that not all whitlow is caused by a bacterial infection, and that it is important to differentiate between herpetic and bacterial whitlow, as these diseases require a different treatment.
Highlights
Whitlow is an infection of a finger or around the fingernails, generally caused by bacterium
He had multiple vesicles on the finger, which led to the diagnosis of herpetic whitlow, which we confirmed by polymerase chain reaction testing
Whitlow is rarely caused by the herpes simplex virus, but this disease requires a swift recognition and treatment to prevent complications
Summary
Whitlow is rarely caused by the herpes simplex virus, but this disease requires swift recognition and treatment to prevent complications. As this treatment differs from that of a traditional whitlow, physicians should be aware of herpetic whitlow. Consent Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Competing interests The authors declare that they have no competing interests. TS revised it critically for important intellectual content. Both authors read and approved the final manuscript
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