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Felon
Understanding a felon, an infection of the fingertip pulp, and why this needs prompt assessment and treatment.
What is a Felon?
A felon is a bacterial infection of the closed, fat-filled pulp space at the fingertip, forming a tense, painful pocket of pus. It usually follows a puncture wound, splinter, or other minor injury to the fingertip that allows bacteria into this closed space.
Felon at a glance
What is it?
A bacterial infection of the closed, fat-filled pulp space at the fingertip
Common symptoms
Intense, throbbing fingertip pain with swelling, tightness, redness and warmth
Who it affects
Anyone with a puncture wound, splinter or minor injury to the fingertip
Is it serious?
Pressure can build quickly in this closed space, so urgent drainage is usually needed
Treatment options
Surgical drainage alongside antibiotics
First step
Urgent assessment to confirm the diagnosis and arrange drainage if needed
Symptoms and how a Felon presents
The main symptom is intense, throbbing pain in the fingertip, often out of proportion to how minor the original injury seemed. This is because the pulp space is enclosed by fibrous tissue and cannot expand as swelling builds. Swelling, tightness, redness and warmth of the pulp are also typical.
Causes and risk factors for a Felon
- A puncture wound
- A splinter
- Other minor injuries to the fingertip
How is a Felon diagnosed?
A felon is usually diagnosed on examination, given its classic appearance and severe pain. An x-ray may be taken to check that the bone is not involved.
Treatment options for a Felon
Because the pulp space is a closed compartment that cannot expand, antibiotics alone are rarely enough once pus has collected. A small surgical drainage procedure to release the pressure and pus is usually needed and provides rapid relief. Antibiotics are usually given alongside drainage.
When to see a hand surgeon about a Felon
Severe, throbbing fingertip pain, especially after a puncture wound or splinter, should be assessed urgently, as prompt drainage prevents more serious spread of infection.
What to expect at your appointment
At urgent assessment, Dr Tomlinson or her team will examine the fingertip and arrange drainage promptly if a collection of pus is confirmed.
Related conditions and treatments
A felon affects the fingertip pulp, which is different from acute paronychia, an infection around the nail. Both are covered under the broader category of hand infections.