A Herpes Labials Infection

The diagnosis is made found on examination, history, and laboratory tests, the definitive tests being viral cultures and the Tzanck test. Herpetic felon is a self-limiting disease, and is usually treated with anti-viral medications to relieve symptoms.

The involved hitchhike is oftentimes exquisitely tender and quite edematous; however, in contrast to felon, the pulp space usually is non tensely swollen3. The pain whitethorn be out of proportion to the palpable symptoms. Examination usually reveals the characteristic grouped vesicular lesions or ulcers with surrounding erythema. The fluid within the vesicles is usually clear, but it whitethorn appear cloudy or hemorrhagic. The infectious process may be extended into the subungual space. Lymphangitic streaking and possible adenopa

thy of the epitrochlear and axillary nodes may be found. There are often preexisting herpetic lesions in the oral cavity or on the genitals.

The definitive tests for herpetic whitlow are the Tzanck test and viral cultures showing the presence of the herpes simplex virus 1 or 2. In the Tzanck test, smears are obtained by scraping the base of an unroofed vesicle. Smears are Giemsa stained, and a positive test in indicated by the light microscopy finding of multinucleated giant cells, often with visible viral inclusions. Viral culture of aspirated vesicle fluid is the most nice assay, but requires 24 to 48 hours. In the case describe here, because the Tranck test was positive, we decided a viral culture would not be necessary.

Diagnosis of herpetic whitlow is usually clinical, and is based on presentation of the affected digit with characteristic lesions and a typic history. In c
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