Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Each of the main finger infections has specific signs and symptoms that make identification unique and can sometimes cause confusion if not properly evaluated.
Paronychia: The area next to the fingernail will appear red and swollen. A visible collection of pus may be seen under the skin and nail. This fluid may be actually leaking out of the wound. The area will be tender and painful to the touch. The drainage from the area is usually a cloudy white-yellow color.
Felon: The fingertip is swollen and painful. The swelling usually develops over several days and is located in the pad area of the fingertip. The area will have a throbbing pain and be painful to the touch. The area is usually red, and a visible collection of pus may be seen under the skin. The swollen area may have a portion that feels soft as if it contains fluid. As the swelling continues, the area may become tense or hard to the touch.
Herpetic whitlow: The fingertip area will be red and tender. A burning or itching sensation may be present in the area. There may be mild swelling but not as extensive as in the felon. There may be a single or many open wounds in the area affected. These open wounds often occur in clusters after the formation of a small blister-like lesion. The fluid in these lesions is usually clear in appearance but may be slightly cloudy.
The affected individual may also have a low-grade fever and have swollen and tender lymph nodes in the area.
Cellulitis: The skin area will be red and warm to the touch. The area may be slightly swollen and tender. This is usually a superficial infection so the deep structures should not be involved. The motion of the fingers and hand should not be difficult or painful. If painful or difficult, this may indicate a deep space infection of some type.
Infectious flexor tenosynovitis: Four major signs often are found with this condition.
First is tenderness over the flexor or palm side of the finger. This pain is found over the tendons in the finger.
Second is uniform swelling of the finger.
Third is pain on extending or straightening of the finger.
Fourth, the finger will be held in a slightly flexed or partially bent position.
These signs are called Kanavel cardinal signs. All four signs may not be present at first or all at once.
Deep space infections: The deep space infection that arises in the web space of the fingers is also called a collar button abscess. The space between the fingers will be painful and swollen. The area may also be red and warm to the touch. As the abscess becomes larger, the fingers will be slightly spread apart by the increasing pressure. The central area may have a soft spot that represents a collection of pus under the skin.
OnychomycosisOnychomycosis is a fungal infection of the toenails or fingernails. Onychomycosis causes fingernails or toenails to thicken, discolor, disfigure, and split. At ...learn more >>
Paronychia (Nail Infection)An infection that develops along the edge of the fingernail or toenail is called a paronychia (pear-ah-NIK-ee-ah). Symptoms and signs include redness and swelli...learn more >>