Use coupon code "ready" for 10% off today! Shop Now
(1)

FAQ’s for Herpetic Whitlow

Physical Signs and Symptoms

  • Involved finger is often exquisitely tender and quite edematous; however, in contrast to a felon, the pulp space usually is not tensely swollen.
  • Examination usually reveals the characteristic grouped vesicular lesions or ulcers with surrounding erythema.
  • Fluid within the vesicles is usually clear, although it may appear cloudy or hemorrhagic.
  • Extension of infectious process into subungual space may be observed.
  • Lymphangitic streaking and possibly adenopathy of the epitrochlear and axillary nodes may be found.
  • Preexisting herpetic lesions may be noted in oral cavity or genitals.


Mode of Infection

  • As noted, health care workers are at risk due to possibility of exposure to virus-containing secretions from their patients.
  • Patients with other herpetic lesions, such as herpes labialis, herpetic gingivostomatitis, or genital herpes, are at risk due to autoinoculation.
  • Immunocompromised patients are at risk for primary infection, reactivation, and possibly systemic complications.

Laboratory Studies

  • Diagnosis of herpetic whitlow usually is clinical, based on presentation of the affected digit with characteristic lesions and a typical history.
  • In children, observation of concurrent gingivostomatitis is almost pathognomonic.
  • In adults, the presence of occupational risk factors or finding of concurrent oral or genital herpes lesions should strongly suggest the diagnosis.
  • Definitive diagnostic testing includes the Tzanck test, viral cultures, serum antibody titres, fluorescent antibody testing, or DNA hybridization.
  • In the Tzanck test, smears are obtained by scraping the base of an unroofed vesicle. Smears are Giemsa stained, and a positive test is indicated by light microscopy findings of multinucleated giant cells, often with visible viral inclusions.
  • Viral culture of the aspirated vesicle fluid is the most sensitive assay, but this test is usually more costly and time consuming, requiring 24-48 hours.
  • Serum antibody titres are usually cost prohibitive, as are fluorescent antibody testing and DNA hybridization, which are not commonly available.

Emergency Department Care:

  • Herpetic whitlow is a self-limiting disease. Treatment is mostly directed toward symptomatic relief.
  • Tense vesicles may be unroofed to help ameliorate symptoms, and wedge resection of the fingernail may be used for the same purpose in cases involving the subungual space.
  • Deep surgical incision is contraindicated, since this may lead to delayed resolution, bacterial superinfection or systemic spread, and complications such as herpes encephalitis.

Follow up Care

  • Advise routine outpatient follow up care to ensure resolution of infection and to monitor for evidence of bacterial super infection.

In/Out Patient Medicines

  • Include analgesics in the treatment of herpetic whitlow.
  • Antivirals may be of benefit in primary infections.
  • In cases of super infection, antibiotics are effective against skin pathogens.

Deterrence/Prevention

  • Avoidance of exposure is the key to prevention of herpetic whitlow.
  • Health care workers should use gloves, practice strict hand washing, and scrupulously observe universal fluid precautions.
  • Studies have demonstrated herpes virus in 2.5% of asymptomatic patients and in 6.5% of hospitalized patients with tracheostomies.
  • Patients with oral, labial, or genital lesions and the parents and caregivers of children with lesions should be cautioned against digital contact with lesions.
  • Complications usually are minimal provided that the affected patients are immunocompetent.
  • Misdiagnosis as a bacterial paronychia or felon with resultant deep incision may lead to delayed resolution, increased risk of bacterial superinfection, systemic spread (rare), and possibly development of herpes encephalitis.
  • Hyperesthesia or numbness has been reported in 30-50% of patients between episodes of reactivation.
  • Other potential complications include scarring of the affected digit and ocular spread.

Prognosis

  • Prognosis is excellent in uncomplicated cases, with spontaneous resolution in 3-4 weeks.

Patient Education

  • Advise patients of the likelihood of future recurrence and warn of the possibility of disease spreading to other parts of the body and to other individuals.

Medical/Legal Pitfalls

  • Misdiagnosis and inadvertent deep incision may result in delayed healing, increased risk of bacterial superinfection or systemic spread, and possibly herpes encephalitis.

Herpetic whitlow is an infection of the finger by the herpes simplex virus (HSV). Herpetic whitlow is typically caused by HSV-1, the type that generally causes oral herpes. Herpes can infect any site on the skin, but the finger is probably the most common. Children newly infected with oral herpes can spread it to their thumbs during sucking. In adults, it also can be spread from an oral lesion, almost always after a primary (new) infection rather than recurrences.

Health care workers such as dental hygienists frequently develop herpetic whitlow after caring for patients with oral herpes. A person infected with HSV can transmit it to others even if he or she has no active lesions, so you may have contracted it from any one of your patients. This infection is just one more reason to wear gloves with every single patient.

Unlike oral and genital herpes, which the infected person can transmit even when he or she has no visible lesions, herpetic whitlow probably is less likely to spread in the absence of lesions. One is probably contagious as long as one has a wet, open lesion. Since it is only on the finger, it is probably not infectious as long as gloves are worn. Herpetic whitlow can recur, though usually not as often as do oral or genital herpes.

As far as a baby is concerned, herpetic whitlow in the mother is not really a cause to worry too much. It is genital herpes that causes most of the problems for newborns. Women who become infected shortly before delivery and have genital lesions at the time of delivery are most likely to transmit the infection to the baby, although individuals with recurrent herpes lesions also can infect the baby during delivery.

Far less common is infection during pregnancy, long before delivery. Infection of the fetus can result in stillbirth and congenital anomalies. Most of the data on transmission to the fetus involve genital herpes, not oral herpes.

How the Infection Develops

After an incubation period of 2 to 14 days, the patient may experience prodromal symptoms, such as fever and malaise. Common initial symptoms of infection include tingling pain or tenderness in the affected digit, followed by throbbing pain, swelling, and redness. Vesicles, which form over the next week, contain fluid that may be clear, bloody, or cloudy. While these vesicles are present, herpetic whitlow is extremely contagious.

About 2 weeks after vesicles first appear, a crust forms over them. This signals the end of viral shedding.

If untreated, the infection usually resolves in 3 to 4 weeks. Treatment with antiviral medication may speed healing and reduce viral shedding, but some patients never regain full sensitivity or range of motion in the digit.

Herpetic whitlow vesicles are susceptible to secondary bacterial infections. Signs and symptoms of a secondary infection include fever, chills, red streaks the length of the arm, lymphadenopathy, and fatigue.

After healing, about 20% to 50% of the patients experience recurrences, which may be triggered by trauma, febrile illness, disease, or other physiologic changes. The recurrence usually is milder and clears up faster than the original infection.

The health care provider will base her diagnosis on signs and symptoms and confirm it with lab testing Options include isolating the virus from a sample of vesicular fluid, a Tzanck test (a stain histology test), and serum immunoglobulin antibody testing for HSV IgM (to detect acute HSV) and IgG (to detect a history of HSV).

Treatment and Prevention

To treat herpetic whitlow, the health care provider will order an oral, topical, or I.V. antiviral medication. These medications accelerate healing, reduce viral shedding and pain, and may help prevent a recurrence. Prescriptions for secondary infection may be given, if indicated. Incision and drainage of vesicles isn’t indicated because this may spread the infection.

Finger Herpetic Whitlow Picture

Finger Herpetic Whitlow

Herpes Treatment– A beautiful melange of time-tested resonance homeopathic medicines and homotoxological remedies so as to stimulate the immune system to heal itself following nature’s laws.

Symptoms caused by HSV 1 infection (HSV 1 is known to affect the following areas of the body.)

After reviewing the following data you are now in a position to take an informed decision. We hope you make the right choice and we will be with you on your journey to recovery. Please get in touch with any of our Doctors if you need any further information.

To regain your life and freedom CLICK HERE!

MEDICAL DISCLAIMER

All our products are made in FDA compliant GMP certified Laboratories in Germany, Switzerland, USA, India, and Spain. They are appropriately registered with the FDA as Dietary supplements, Homeopathic attenuations or Ayurvedic herbs. Utmost care is taken to ensure optimum quality and purity. Biogetica is a website visited from across the globe. Some countries consider Ayurveda, TCM, Supplements, Bioenergetics and Homeopathy to be medicine, while others do not. In order to comply with various FDA norms of numerous nations we say:

Ayurveda & Homeopathy may or may not qualify as medicine in your home jurisdiction. The complementary advice of our practitioners who are considered Homeopathic and Ayurvedic Doctors in some jurisdictions does not replace the medical advice given by your primary care physician. Biogetica’s Homeopathic products may be used for treatment of self limiting over the counter ailments in USA, India & Europe that support Homeopathy for OTC use. Biogetica’s Herbal remedies from the Ayurvedic, Chinese and other traditions may only be used to balance the 5 elements and rejuvenate organ systems in countries where Herbs, Ayurveda and TCM are not considered medicine. Biogetica’s ground breaking supplements may only be used to support the ideal structure and function of the various systems in the Human Body.

Information provided on this website has not been evaluated by the Food and Drug Administration. Our products are not intended to diagnose, treat, cure or prevent any disease.

* This peer reviewed and published research has most probably not been studied or approved by the FDA in your country as a treatment or cure. Hence no disease claims can be made and you are welcome to take the natural ingredients for (immunity, lung health, cardiovascular health, etc). Homeopathy is medicine in USA but only for OTC issues. Ayurveda is medicine only in India and TCM is medicine only in China. Switzerland supports insurance payments for Homeopathy.

As per the FTC Enforcement Policy Statement on Marketing Claims for OTC Homeopathic drugs anyone selling homeopathy must state.

There is insufficient scientific evidence that homeopathy works, and

The product’s claims are based only on theories of homeopathy from the 1700s that are not accepted by most modern medical experts.

** Our remedies have been traditionally used in Ayurveda and Homeopathy for centuries. Each remedy has a varying amount of modern research behind it. We, in abiding by the law make no claims of a miracle cure or permanent results. Individual results may vary from individual to individual.

*** Try our Products Now! Our Unconditional 100 % Money Back Guarantee is Valid for 90 days.

† All Homeopathic products are made in accordance with the Homeopathic Pharmacopoeia of the United States, a document which has been published for over 100 years and which is recognized as an “official compendium” by Sections 501(b) and 502(e)(3) of the Federal Food, Drug, and Cosmetic Act, 21 U.S.C. 351(b) and 352(e)(3) (“FD&C Act”).” These indications are based solely on traditional homeopathic use. They have not been evaluated by the Food & Drug Administration.

†† These testimonials are unsolicited and unedited except for the name of the sender. They contain the senders’ initials or first name only for purposes of privacy. These are actual emails from many we were able to help over the years. Testimonials represent a cross section of the range of outcomes that appear to be typical with these products. Your results may vary. We do however stand by our products and will refund you completely if our products don’t meet your expectations.

What we do is simply point you and your Doctors to independent research from all sources that we know of, on the ingredients or entire formulation of our natural products, which are Herbal, Ayurvedic, Bioenergetic, Homeopathic and Complementary in nature. We invite you to read these studies on our clinical trials page or on scholar.google.com. Results may vary from person to person as is depicted in the wide range of results seen in the clinical trials.

 

 

1
1
Your Cart
TALVAAR 30 Capsules
Price: $19.00
- +
$19.00
Calculate Shipping
Shipping to:FL, United States (US)
Apply Coupon

Use coupon code "ready" for 10% off today!