Infected Acute Cutaneous Injury
A 32-year-old woman presents with a swollen, painful fourth digit on the right hand. While housecleaning, a traumatic erosion developed on the ipsilateral hyponychium.
A 32-year-old woman presents with a swollen, painful fourth digit on the right hand. While housecleaning, a traumatic erosion developed on the ipsilateral hyponychium. Despite the injury, she continued her chores, necessitating putting the affected finger into dirty environments.
Key point: There is clearly a degree of cellulitis present: well-demarcated erythema and swelling with subjective pain. Despite the patient’s best intentions, continuing to clean in spite of a fresh, open wound was not a good decision.
Treatment: Oral doxycycline, 100 mg twice daily, was started promptly. After 14 days, all signs and symptoms had abated.
Note: Infected acute cutaneous injuries should be presumed to be caused by Staphylococcus aureus. MRSA may also be suspected in communities with a high prevalence of this organism as a pathogen.
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