Herpetic Whitlow

Herpes simplex virus 2 is the main reason for causing painful infection on the fingers which is called as herpetic whitlow. Both HSV 1 and HSV 2 are responsible for causing this infectious disease on hands. There would be considerable pain with swelling of fingers and predominantly it affects index finger and thumb. It would start as low grade fever prior to the infection of fingers. The chance of getting infection is more in workers who work in atmosphere prone to waste materials or genital secretions. The infection spreads if anyone comes into direct contact with affected person. Since HSV virus easily infects people who does not follow hygiene in toilet training children are prone to get this infection easily.

Symptoms :

The disease is characterized by reddish spots or lesions on the fingers. The index finger or the thumb is mostly affected with infection. There would be severe pain with inflammation of the fingers. The fingers become tender and edematous and look swollen. It would be difficult to carry on daily routine in using the fingers for writing or holding anything. You can observe the group of lesions or bumps present in the fingers which is filled with pus like fluid. The drainage is mostly clear but sometimes cloudy containing traces of blood in it. The infection will easily spread to other parts of the fingers and hands. Lesions are rarely formed in mouth and genital area.

The virus will begin its attack anywhere from 2-20 days of entering the body. Extreme tiredness and reduced physical sensation in the finger is the major sign of this disease. Blisters will be formed at the end of 7-10 days and the lymph nodes below the armpit become unusually tender.

Who are at risk?

People who are frequently in contact with HSV type of virus at workplace are at constant risk of getting herpetic whitlow. Group of individuals working as doctors, nurses and in beauty salons belong to this category. If a woman engages sexually with her partner having infection on his genitals then she has increased chance of getting the same infection. Since the infection often spread through fingers, it is necessary to educate children to wash their hands after using toilet and before eating food.

Causes :

Herpes simplex virus is the major cause for this disease. People who are exposed to virus in workplace and those who are following poor hygiene in toilet are prone to get this infection. Individuals who are affected with herpes lesions and herpes labialis are at the risk of getting herpetic whitlow due to auto-inoculation. People affected with autoimmune disorders like HIV, cancer etc have increased chance of getting infected.

Diagnoses :

The doctor can identify the infection by looking at the lesions on the fingers. Further he may ask you about the history of workplace or your habit of using public toilets. He would collect few drops of liquid from the lesions and perform viral culture test or Tzanck test for identifying the virus.

Treatment :

Treatment is given initially for removing the symptoms of inflammation and pain on the fingers. Acyclovir is prescribed either orally or as topical cream which can provide great relief to reduce the symptoms.

High dosage of this medicine can also reduce the risk of getting infected again. Valacyclovir or Famciclovir are also given for treating herpetic whitlow. The purpose of taking this drug is to prevent inoculation of spreading this infection orally or transmitting the infection to others. These drugs are effective in preventing complications and decrease the rate of transmission. Very often the same drugs are used for treating HSV 1 and 2. Apart from antiviral medicines the infected person will be given Ibuprofen for tolerating pain.

After complete recovery, the virus may still remain dormant on the person and move to peripheral ganglia. It may recur second time but the symptoms are not that severe and the infection will settle in few days.

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Prevention :

Do not share towels and use public toilets. To avoid spreading, cover the infected blisters with dry plaster. Doctors and nurses who treat HIV patients should wear rubber gloves. Beauty therapists should avoid treating individuals with herpes infection.

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