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Coexistent infections on a child's distal phalanx: blistering dactylitis and herpetic whitlow
Amy C Ney1, Joseph C English, Kenneth E Greer
1Department of Dermatology, University of Virginia Health System, Charlottesville 22908-0718, USA.
Insights
A child presented with a blistering and vesicular eruption on their finger due to coexisting Staphylococcus aureus and herpes simplex virus (HSV) infections. This rare dual infection highlights the importance of considering multiple pathogens in blistering distal dactylitis (BDD).
Area of Science:
- Pediatrics
- Infectious Diseases
- Dermatology
Background:
- Blistering distal dactylitis (BDD) typically presents as a superficial infection of the distal finger in children.
- BDD is commonly caused by beta-hemolytic streptococci or Staphylococcus aureus.
- Herpetic whitlow, another blistering finger infection in children, is caused by herpes simplex virus (HSV-1 or HSV-2) and is sterile.
Observation:
- This case report details a child with a bullous and vesicular eruption on the distal phalanx.
- The eruption was found to be caused by a coexistent infection of Staphylococcus aureus and herpes simplex virus.
Findings:
- Coexistence of Staphylococcus aureus and herpes simplex virus infections can occur on the distal phalanx.
- This dual infection presented as a bullous and vesicular eruption in a pediatric patient.
Implications:
- Recognizing the possibility of coexisting bacterial and viral infections is crucial for accurate diagnosis.
- This case underscores the need for comprehensive diagnostic approaches in pediatric blistering hand diseases.
- Appropriate and timely treatment strategies may need to account for polymicrobial etiology.
Abstract:
We report a case of coexistent Staphylococcus aureus and herpes simplex virus (HSV) infections responsible for a bullous and vesicular eruption on a child's distal phalanx. Blistering distal dactylitis (BDD), a superficial infection of the distal portion of the finger, is seen most commonly in children and is caused by either beta-hemolytic streptococci or S aureus. Herpetic whitlow, also a blistering infection found on children's distal fingers, is a bacteriologic sterile infection caused by HSV-1 or HSV-2. In this report, we note that these infections may coexist on the distal phalanx. This case has implications for diagnosis and treatment of children's blistering hand diseases.