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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

  • Cellulitis
  • Paronychia
  • Herpetic Whitlow
  • Flexor Tendon Tenosynovitis

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