Terminal Pulp Space Infection

Terminal Pulp Space Infection

The palmar side of the tips of the fingers and thumb (terminal phalanx) in hand are called the pulp spaces. These pulp spaces are filled with fatty tissues which are divided into various compartments by the fibrous septa. These pulps spaces can be infected by various organisms. Infection of these pulp spaces is called as whitlow or felon. It is the second most common infection of hand.

Causes and risk factors

Invasion of these pulp spaces with infective agents, particularly bacteria, is the most common cause. They are introduced through a pinprick or through sewing needle.

 

Clinical presentation:

Involvement of the index finger and thumb are more commonly seen. The characteristic features are severe throbbing pain and tenderness at the tip of the affected finger. The pulp is swollen and in some cases suppuration can be seen.

 

Investigations:

The narration of the suffering by the patient and the local examination carried out is sufficient for confirming the diagnosis. If required, routine blood test and cultures can be carried out.

 

Treatment:

In mild cases, conservative line of treatment is sufficient to allay the complaints. Antibiotics are prescribed. In case where suppuration is seen, the pus needs to be drained out. The incision is taken directly on the center of the abscess or lateral incision is made.

 

Other Modes of treatment:

Certain other modes of treatment can also be helpful in coping up with the symptoms. Taking into consideration the symptoms in a holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints.

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