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Beverly Hills
9301 Wilshire Boulevard
Beverly Hills, California 90210
Wilmington
123 F St., Suite G
Wilmington, California 90744
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INSURANCE & WORKERS' COMPENSATION
ACCEPTED!
We accept most types of insurance
providers and specialize in the treatment of workers'
compensation injuries to the hand and upper extremity. |
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Hand Infections
Paronychia Infection
Felon Infection
Herpetic Whitlow Infection
Septic Arthritis and Osteomyelitis
Infection
Deep Space Infection
Tendon Sheath Infection
Atypical Mycobacterial Infection
Bite Wonds Infection
All hand infections require urgent treatment!
If not treated promptly, a hand infection can result in severe problems
including stiffness or loss of strength and the loss of skin, nerves,
and bone even after the infection has been treated. Therefore, it
is vitally important that any hand infection is treated early and
aggressively by your hand surgeon
If the infection is noticed and caught early enough, it may be one
that can be treated with antibiotics and rest. Your hand surgeon will
determine how to treat the infection after examining it, but you must
visit your doctor as soon as you suspect infection. Severe problems
can start in as little as a day or two unless the infection is treated
with antibiotics, infected tissues are removed, and the wound is surgically
drained. To determine the nature of the infection or the type of bacteria
that is causing it, any fluids or pus draining from the site should
be sent to a laboratory for testing.
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| Paronychia Infection |
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A paronychia is an infection caused by bacteria that is located around
the cuticle surrounding the fingernail (figure 1). If it is a case
of acute paronychia, you will notice redness, swelling, and pain in
the area, and it may produce pus if left untreated.
If caught early enough, paronychia can often be treated with antibiotics
and soaking, but if it is the source of pus, additional steps may
be needed. In more-advanced cases, the cuticle and nail may need to
be lifted up and drained, or the infected area may need to be lanced
by a hand surgeon.
If the paronychia is caused by a fungus and the cuticle is only mildly
red and swollen with little or no discharge and slight tenderness,
it is considered a case of chronic paronychia. People whose hands
are often wet, such as dishwashers or bartenders, are likely to develop
this condition. It can often be treated with special medication and
with changes or elimination of the constant moisture that enables
the fungus to grow. Sometimes the skin or other infected tissue needs
to be surgically removed, and people who suffer from chronic paronychia
often need lengthy treatment.
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| Felon Infection |
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Felon infections are more serious and usually more painful than paronychia.
A felon infection is located under the fingertip and often throbs.
An infection of this type usually requires surgery to drain the infected
site, and antibiotics are often used to treat the infection. If felon
infection is not recognized and treated early enough, it can destroy
the soft tissues at the fingertips and even the bone.
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| Herpetic Whitlow Infection |
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One viral infection that healthcare workers in particular are susceptible
to, because of exposure to people who carry the herpes virus, is herpetic
whitlow. This infection, which comes from the herpes virus, can appear
anywhere on the hand, but usually shows up on the fingers in the form
of tiny blood blisters that are painful. A herpetic whitlow infection
can also cause numbness and is usually treated with medication for
a period of weeks.
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| Septic Arthritis and Osteomyelitis Infection |
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Septic arthritis can result from a wound near one of the joints or
from a nearby arthritic joint that drains and infects it. In a matter
of days, if untreated, the bacteria causing the infection can destroy
all the cartilage that lines the joint. To treat septic arthritis,
antibiotics and surgery to drain the infection are used, and must
be done promptly to prevent the infection from spreading to the bone
in a condition called osteomyelitis. It may take more than one surgery
to get rid of all the infected tissue, and many patients need weeks
of intravenous antibiotics before treatment can be stopped.
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| Deep Space Infection |
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Deep space infections are those effecting deep areas of the hand.
These spaces can become infected, usually from a puncture-type wound,
and may show up in the thenar space, near the thumb, in the deep palmar
space of the palm, or even in the webs between the fingers in a collar-button
or web space abscess. Any infection in the deep spaces of the hand
needs to be surgically drained by your hand surgeon, and if left untreated,
can spread and even infect the wrist and forearm.
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| Tendon Sheath Infection |
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Any small cut or puncture in the middle of a finger can lead to an
infection of the flexor tendon,
especially if the wound is near a joint on the inside of the finger.
An infection of the flexor tendon often causes the finger to become
very stiff and can lead to the tendon becoming ruptured and destroyed.
The infected finger is often stuck in a slightly bent position, stiff,
and red, and swelling is common. The inside of the finger, near the
palm, is frequently tender, and any attempt to straighten the finger
out creates severe pain (figure 3). To treat a tendon sheath infection,
a hand doctor will surgically drain the tendon sheath, and antibiotics
will be given.
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| Atypical Mycobacterial Infection |
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The tendon sheath can also be infected by an atypical mycobacterium,
though this is less common than an infection that comes from a cut
or puncture. An infection of this type usually grows slowly, and while
the infected finger may show swelling and become stiff, there usually
isn't any pain or redness. To treat this type of infection, several
months of special antibiotics are used, and surgery to remove the
infected lining that surrounds the tendon may be required. Even after
being treated, some remaining stiffness is common.
An atypical mycobacterial infection can infect other parts of the
hand and isn't limited to the joints in the fingers. A common form
of this is mycobacterium marinum, which can come from deep punctures
from fish spines or from a contamination that comes from stagnant
water, or from any other simple wound. The source of the contamination
can either be a pond or puddle in nature, or can even come from a
home aquarium.
It isn't always easy to identify the specific organism that is causing
the infection, but that isn't necessary for the infection to be treated.
Those who have an impaired immune systems are more likely than the
general population to develop an atypical mycobacterial infection.
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| Bite Wounds Infection |
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Animal and human bite wounds
are very common and can lead to an infection because of the high number
of bacteria that live in the mouth. An infection that comes from a
bite can be caused by any one of a number of bacteria.
Streptococcus can be involved, as can staphylococcus, which results
from a tooth going below the surface of the skin. Other organisms
that are common in the mouth can cause other infections and may need
other or extra antibiotics to be successfully treated. Human bites
often produce eikenella corodens, and Pasteurella multocida arises
from dog or cat bites.
In all bites, the wound is usually left open after being cleaned and
treated to let any infection drain out. Since the bite can cause an
infection in a deep structure like a joint or knuckle, the area of
the bite needs attention. To treat the infection, it may be necessary
for your hand surgeon to trim away any infected tissue, including
any bones that may have been crushed. If the bite came from an animal,
the possibility of rabies is very real and since it can lead to serious
or even fatal results, very serious. The risk of rabies infection
determines the treatment plan your doctor will provide, and, fortunately,
reported human cases of rabies are rare. The chances of a domestic
animal having rabies is small, and most cases come from wild animals
such as skunks, bats, or other rodents.
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