Learning from Mistakes – a Case of Pediatric Patient with Recurrent Whitlow

Abstract

Background: Herpetic whitlow is a herpes simplex virus infection of the fingers or thumb characterized by erythema accompanied by painful non-purulent vesicles.  Aim: To draw attention to the typical appearance of herpetic whitlow and to distinguish it from bacterial infections and other skin diseases because of their different management. Materials and methods: The patient’s history, dermatological status, and scrapings from the vesicles were taken. The swabs were cultured for isolation of bacteria and fungi. DNA extraction and PCR were performed for detection of HSV.  Results: Repeated identical infections of the finger were found in the patients’ history, commonly associated with respiratory infections. The cultured swabs for bacterial or fungal detection remained negative. The scraping from vesicle used for viral detection showed positive HSV result. Conclusion: It is important to distinguish herpetic whitlow from infectious and skin diseases and to learn from yet done mistakes - the patient was previously diagnosed with bacterial whitlow, contact dermatitis and dermatitis of unknown origin.