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Hand Infections
Understanding the range of infections that can affect the hand, from minor skin infections through to deeper infections that need urgent treatment.
What are hand infections?
The term ‘hand infections’ covers a wide range of conditions, from minor skin infections through to more serious infections involving the deeper tissues, a tendon sheath, or a joint. They usually follow a cut, splinter, puncture wound, bite, or spread from a nearby skin infection. Some specific types, such as felons and acute and chronic paronychia, are covered on their own dedicated pages.
This page talks about bacterial infections, not fungal (commonly nail) infections. Fungal nail infections are best managed by a general practitioner, dermatologist or infectious disease physician.
Hand infections at a glance
What is it?
Infections affecting the skin, soft tissue, tendons or joints of the hand
Common symptoms
Redness, warmth, swelling and pain (constant throbbing), sometimes with pus, fever or reduced movement
Who it affects
Anyone with a wound, cut, bite or puncture to the hand
Is it serious?
Most are minor, but deeper infections (those affecting tendons or joints) can spread quickly and need urgent treatment
Treatment options
Antibiotics for minor infections, surgical drainage for deeper infections
First step
Prompt examination to assess how deep and how serious the infection is
Symptoms and how hand infections present
The main symptoms are redness, warmth, swelling and increasing, persistent, throbbing pain over the affected area, sometimes with pus or discharge. Reduced movement of the finger or hand, and fever or feeling unwell, point towards a more significant infection.
Causes and risk factors for hand infections
- A cut, splinter or puncture wound
- A human or animal bite
- Spread from a nearby skin infection
- Diabetes or a weakened immune system, which increase the risk of a more serious infection
How are hand infections diagnosed?
Diagnosis is based on examination of the affected area. Blood tests or imaging, such as an x-ray or ultrasound, are sometimes used if a deeper infection or a retained foreign body is suspected.
Treatment options for hand infections
Many minor infections respond well to oral antibiotics and simple wound care such as elevation and dressings. However, minor infections generally do not reach the attention of a hand surgeon.
Infections that involve a tendon sheath, a joint, or a deep space in the hand generally need urgent surgical washout in addition to antibiotics, as these can spread quickly and threaten the function of the hand if treatment is delayed.
In addition to antibiotic therapy, non surgical methods that tip the balance more in the favour of the patient than the infection include
- rest (reclining at home, not working or exercising)
- strict elevation (hand elevated above the level of the heart in a sling or box arm sling)
- strict immobilisation of the hand and wrist in a forearm based plaster
- optimisation of glucose control in diabetes
- Promoting release of pus and removal of any source of infection – this may involve water soaks for paronychia, removing a splinter, regularly cleaning an infected wound of dirty tissue
When to see a hand surgeon about hand infections
Any hand infection that is rapidly spreading, associated with fever, affecting movement of the finger, or not settling with simple measures should be assessed urgently.
What to expect at your hand infection appointment
At assessment, Dr Tomlinson or her team will examine the affected area and arrange prompt treatment with antibiotics and, if needed, surgical drainage.
Because hand infections such as flexor tenosynovitis (infection of the flexor tendon sheath) and septic arthritis (joint infection) are surgical emergencies requiring prompt admission to hospital and washout we will routinely ask that you send photographs of the area so that we can triage appropriately prior to any appointment.
If we are unable to personally facilitate prompt hospital admission and surgical washout then we will recommend that you present to the nearest hospital emergency department for admission and treatment, so your treatment is not delayed.
Related conditions and treatments
Specific types of hand infection are covered on their own pages, including felon, a fingertip pulp infection, and acute paronychia and chronic paronychia, infections around the nail.