Infection of the pulp of the finger (felon)

Hands | Emergency Medicine | Infection of the pulp of the finger (felon) (Disease)


A felon is an infection of the fingertip pulp that come in two forms: cellulitis, which is a non-pus forming infection, and an abscess (a cavity of pus). They usually start out as only slightly tender but can rapidly progress to extremely painful. These fingertip infections usually come from some type of penetrating injury, such as a small laceration (cut) or a splinter, but sometimes we cannot find any specific reason.

Causes and Risk factors

Felons usually are caused by Staphylococcus aureus bacteria. It is important to get treatment quickly for these small abscesses. If the bacteria pocket continues to expand, it can compress blood vessels in the finger and cut off the fingertips circulation, causing in permanent damage to the finger. Also, an untreated felon can spread its infection to the bone within the finger, creating a more serious infection, called osteomyelitis, that takes much longer to cure. Like other types of infections, felons sometimes begin after the finger is punctured by a wood splinter or something else.

Diagnosis and Treatment

The treatment depends on the form or stage of the infection. If the problem is only a cellulitis, hot soaks and oral (pills by mouth) antibiotics will do the trick, but close observation (office visits every other day or so) is needed. If the felon has progressed to the point of forming an abscess, surgical drainage is needed. The diagnosis of which stage the felon is in can be very difficult, because they both are red, swollen, and very painful, and the treatment is completely different for each stage. It is important to see a skilled hand surgery specialist. The prognosis is excellent if the infection is treated properly. ...

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