Download PDF
J Hand Microsurg 2022; 14(03): 197-199
DOI: 10.1055/s-0040-1710199
Original Article

Herpetic Whitlow of the Hand in Infants

Mohammad M. Al-Qattan 
1   Division of Plastic and Hand Surgery at King Saud University, Riyadh, Saudi Arabia
,
Nada G. AlQadri
2   Department of Surgery, College of Medicine, AlFaisal University, Riyadh, Saudi Arabia
,
Ghada AlHayaza
2   Department of Surgery, College of Medicine, AlFaisal University, Riyadh, Saudi Arabia
› Author Affiliations Funding None.
› Further Information
    Permissions and Reprints

Abstract

Introduction Herpetic whitlows in infants are rare. Previous authors only reported individual case reports. We present a case series of six infants.

Materials and Methods This is a retrospective study of six cases of herpetic whitlows in infants seen by the senior author (MMA) over the past 23 years (1995–2017 inclusive). The following data were collected: age, sex, digit involved in the hand, mode of transmission, time of presentation to the author, clinical appearance, presence of secondary bacterial infection, presence of other lesions outside the hand, method of diagnosis, treatment, and outcome.

Results All six infants initially presented with classic multiple vesicles of the digital pulp. In all cases, there was a history of active herpes labialis in the mother. Incision and drainage or deroofing of the vesicles (for diagnostic purposes) resulted in secondary bacterial infection.

Conclusion The current report is the first series in the literature on herpetic whitlows in infants. We stress on the mode of transmission (from the mother) and establishing the diagnosis clinically. In these cases, no need for obtaining viral cultures or polymerase chain reaction; and no medications are required. Once the vesicles are disrupted, secondary bacterial infection is frequent and a combination of oral acyclovir and intravenous antibiotics will be required.

Keywords

herpes simplex - herpetic whitlow - hand - infants


Publication History

Article published online:
28 April 2020

© 2020. Society of Indian Hand Surgery & Microsurgeons. All rights reserved.

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Rubright JH, Shafritz AB. The herpetic whitlow. J Hand Surg Am 2011; 36 (02) 340-342
    CrossrefPubMedGoogle Scholar
  • 2 Mohler A. Herpetic whitlow of the toe. J Am Board Fam Pract 2000; 13 (03) 213-215
    CrossrefPubMedGoogle Scholar
  • 3 Murphy AP, Martin P, Jukka CM, Memon A, Ng SM. Recurrent primary paediatric herpetic whitlow of the big toe. BMJ Case Rep 2013; 2013: bcr2013008598
    CrossrefPubMedGoogle Scholar
  • 4 Ney AC, English III JC, Greer KE. Coexistent infections on a child’s distal phalanx: blistering dactylitis and herpetic whitlow. Cutis 2002; 69 (01) 46-48
    PubMedGoogle Scholar
  • 5 de Ocariz MM, Vega-Memije ME, Muñoz-Hink H. A case of herpetic whitlow associated with erythema multiforme. Pediatr Dermatol 1998; 15 (05) 384-385
    CrossrefPubMedGoogle Scholar
  • 6 Jordan MB, Abramo TJ. Occurrence of herpetic whitlow in a twelve-day-old infant. Pediatr Infect Dis J 1994; 13 (09) 832-833
    CrossrefPubMedGoogle Scholar
  • 7 Feder Jr HM. Herpetic whitlow in an infant without defined risks. Arch Dermatol 1995; 131 (06) 743-744
    CrossrefPubMedGoogle Scholar
  • 8 Karpathios T, Moustaki M, Yiallouros P, Sarifi F, Tzanakaki G, Fretzayas A. HSV-2 meningitis disseminated from a herpetic whitlow. Paediatr Int Child Health 2012; 32 (02) 121-122
    CrossrefPubMedGoogle Scholar
  • 9 Patel R, Kumar H, More B, Patricolo M. Paediatric recurrent herpetic whitlow. BMJ Case Rep 2013; 2013: bcr2013010207
    CrossrefPubMedGoogle Scholar