Closed fist infection: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
**Pain/swelling over dorsal aspect of MCP joint (most commonly third, fourth, and/or fifth MCP joints) | **Pain/swelling over dorsal aspect of MCP joint (most commonly third, fourth, and/or fifth MCP joints) | ||
==Diagnosis== | |||
*Imaging indicated to rule-out fracture, tooth fragments | |||
==Treatment== | |||
*Prophylactic abx should be initiated for all but the most superficial wounds | |||
**If no visible signs of infection: | |||
***Amoxicillin-clavulanate 875/125mg PO BID x5d | |||
**For signs of infection: | |||
***Ampicillin-sulbactam 1.5gm IV q6h OR cefoxitin 2gm IV q8h OR piperacillin/tazobactam 3.375gm q6h | |||
***Penicillin allergy: clindamycin plus ciprofloxacin | |||
==See Also== | ==See Also== | ||
Revision as of 04:59, 25 February 2012
Background
- Result of striking another individual's teeth with clenched fist
- Although may appear benign, significant morbidity can result from late presentation or inadequate initial management
Clinical Features
- Pain/swelling over dorsal aspect of MCP joint (most commonly third, fourth, and/or fifth MCP joints)
Diagnosis
- Imaging indicated to rule-out fracture, tooth fragments
Treatment
- Prophylactic abx should be initiated for all but the most superficial wounds
- If no visible signs of infection:
- Amoxicillin-clavulanate 875/125mg PO BID x5d
- For signs of infection:
- Ampicillin-sulbactam 1.5gm IV q6h OR cefoxitin 2gm IV q8h OR piperacillin/tazobactam 3.375gm q6h
- Penicillin allergy: clindamycin plus ciprofloxacin
- If no visible signs of infection:
See Also
Source
Tintinalli