Infectious Disease Compendium

Paronychia

Diagnosis

Infection of the base of the nail bed, often quite painful as the pus is trapped by the nail.

Epidemiologic Risks

Wet hands or hands in rubber gloves.

Microbiology

Acute: usually S. aureus.

Chronic: usually Candida or gram negative rods such as Pseudomonas.

Empiric Therapy

May need to be drained, heating a paper clip red hot and sticking it into the abscess though the nail is said to be efficacious. And I bet it really stinks.

Acute: cephalexin OR dicloxacillin.

Chronic: get cultures.

Pearls

Rants

ICD9 Codes (Soon to be supplanted by ICD10)

Paronychia 681.9; candidal (chronic) 112.3; chronic 681.9; finger 681.02; toe 681.11.