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Hand Case 14 Background

A felon is an infection of the distal finger pulp. The finger pulp is divided by fibrous septae extending from the periosteum to the dermis, creating 15-20 non-compliant small compartments in the fingertip. Abscess formation in these compartments causes significant pain and without treatment, can lead to tissue necrosis and osteomyelitis [1]. It can occur after a known insult (i.e. thorn, splinter, paronychia, etc) however some may have no identifiable precipitating etiology.

The most common organism identified is Staphylococcus aureus. In immunocompromised patients, consider co-infection with gram-negative organisms [2].