Infections About the Hand

Infections of the hand are very common. They often result from untreated injuries, which rapidly affect underlying tissues, leading to loss of function or even permanent disability. Proper treatment is essential for excellent results. Although most cases are not urgent, others require proper diagnosis and even surgical treatment. Sometimes the infection resolves with medical treatment when diagnosed early. Severe infections, superficial or deep abscesses, flexor tenosynovitis, septic arthritis, necrotizing fasciitis, and osteomyelitis, for example, must be quickly identified, as they have become a challenge because of pathogen virulence, polymicrobial etiology, and antibiotic resistance. Different pathogens can cause hand infections, but the most commonly implicated ones are Staphylococcus aureus and Streptococcus spp. Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) accounts for over 65% of Staphylococcus aureus isolates, complicating antibiotic therapy. Proper treatment of hand infections requires accurate and prompt diagnosis and correct choice of antibiotics, along with surgery, swelling control, and/or immobilization that is short enough to prevent joint stiffness or contractures. The most common site for hand infections is the dorsum and its subcutaneous tissue, and the most common mechanism is trauma. The disease severity and progression are influenced by pathogen virulence, immune status, anatomical location, intravenous drug abuse, diabetes mellitus, and steroid use. Severe infections most commonly require surgical treatment.