Herpetic whitlow is a viral infection caused by the herpes simplex virus. The virus, when in the active phase spreads easily by simple contact of the skin. Usually it is the terminal phalanx of the finger that is affected. The finger becomes painful, with redness, swelling and itching. The inflamed area then develops blister like eruption with fluid filled with clear liquid. Along with these symptoms many patients also have fever. The lymph nodes become swollen and enlarged indicating infection.
Herpetic whitlow is caused by HSV1 and HSV2 types of virus. Though incidences of infection are more common with HSV1, HSV2 more often affect the adult population with genital sores. HSV1 type virus affects the children with cold sores and blisters in the mouth. Those children who have a habit of sucking or chewing fingers can easily spread the infection. The virus remains dormant for almost 2 to 3 weeks post inoculation. Later, the finger becomes inflamed, painful and red with burning and tingling sensation. Small vesicular rashes and blisters are formed. This symptomatic phase lasts for almost 10 days, and it is during this phase that the virus is active and contagious. Later the crusts begin to dry and the blisters are no more infectious.
Treatment and preventive measures
Whitlow is usually treated as per the symptoms. A painkiller or an antipyretic can help reduce the pain or the fever. Since the infection has a pattern and course, it passes away within a certain time frame. Taking medicine helps to prevent complications like bacterial infection of the blisters. Those with a poor immune system like those who are HIV infected are more susceptible to complications and hence special care must be taken. It is always better to avoid using others personal items like towels or handkerchiefs. Children should be prevented from chewing fingers or biting nails. Healthcare professionals like dentists or nurses are most exposed to the virus and should always use gloves to avoid direct contact with the infected. Bandaging the affected finger always helps restrict the spread, and also helps avoid the blister breaking.
Recurrence of infection
The chances of recurrence of infection by HSV are almost 20% to 50 %. However the intensity of suffering or severity is far less with the following attacks. This is because the body has developed immunity to the virus and is better prepared with antibodies.
Herpetic whitlow being contagious can be effectively controlled by understanding the symptoms and avoiding contact by isolation in the active phase of the infection.
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