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Herpetic Whitlow B00.89 054.6

 
  • synonyms: Digital tip, hand and forearm infections caused by herpes simplex virus 1 and 2.

ICD-10

  • B00.89:    Other herpesviral infection

ICD-9

  • 054.6 Herpetic whitlow Herpetic felon

Herpetic Whitlow Anatomy

Herpetic Whitlow Clinical Evaluation

  • Generally occur in patients with occupations involving orotracheal contact such as oral hygenists and dentist. Can occur from autoinoculation from genital and oral lesions.
  • Painful vesicles from 2-14 days after exposure and susequently unroof forming characteristic ulcers.
  • Evaluate for lympadenitis.
  • May be associated with fever and malaise.
  • Diagnosis can be confirmed with cultures of vesicular fluid, Tzanck smear or a rise in serum antibody titers. Laboratory confirmation is not necesary for characteristic lesions.

Herpetic Whitlow Xray

  • Consider A/P and lateral of affected digit. Usually not needed lesions are characteristic. Indicated to rule out foreign body and osteomyelitis if any concern exists

Herpetic Whitlow Classification / Treatment

  • Lesions are self-limited and resolve over 7-10 days.

Herpetic Whitlow Follow-up Care

  • Lesions are infections until they are completely epithelialized.
  • Virus enters latent state after infection and may recure. Recurrences can be induced by psychological or physical stress, fever, other infections, and sun exposure.

Herpetic Whitlow Differential Diagnosis

Herpetic Whitlow Complications

  • Superinfection may occur if lesion is mistaken for a felon and is treated with incision and drainage.

Herpetic Whitlow References

  • Abrams RA, JAAOS 1996;4:219

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