CLINICALOBSERVATION
Paronychia of
the Great Toe of Infants
Susannah Walker, M.D.
Ull~II~SL,a’I’~h’S
of stretchable material are currently popular apparel for infants under six months of age. As these are made c~~~ stretchable material, some mothers continue to dress their children in these garments even though the size is too small for the infant. Recently the author cared for a patient with a paronychia of the great toe caused by a poorly fitting undersized infant jumpsuit. Case
Report
A twe~-month-c~lcl white male presented with soft tissue swe!!ing, redness and crusted yellow drainage around the nailbed of his right great toe. He was afebrile. The jumpsuit he was wearing was stretched tightly over both of his great toes. Further questioning of the mother indicated that she had been dressing him in yjumpsuits that had been purchased for him when he was a neonate. Therapy consisted of oxacillin 50 mg/kg/day and avoidance oF jumpsuits; resolution of the paronychia occurred in five days.
possibly fc~~al ischemia enhancing the development of infection after minor trauma. The antibiotic treatment chosen for therapy of the paronychia was based upon the fact that penicillin-resistant Stc~phyh~coccr.s’ aureus and CFrcxzc~ ,~# beta hemolytic streptococcus are ~s~zz~monly the cause of paronychia.1 1 usually these primary l~sir~ns are similar tQ soft tissue cellulitis at other sites and are not followed by the development of chronic paronychia, a troublesome condition caused by different etiologic agents.~’~ Mothers should be urged to use only properly fitting jumpsuits. Paronychia of the great toe may occur if the baby is dressed in tion
or
undersized garments.
~~k~~~lee~g~~:~~ The author expresses her appreciation for his interest and review of the
Dodge
Dr. Philip R. manuscript.
to
Comment
The undersized jumpsuit
likely produced primary trauma with subsequent infecFrom The Edward Mallinckrodt
most
Department of Pedi-
atrics, Washington University School of Medicine, and The Division of Ambulatory Pediatrics, St. Louis Children’s
Hospital,
St. Louis,
Missouri.
References 1. Eaton, R. G., and Butsch, D. P.: Antibiotic guidelines for hand infections.
Surg. Gynecol.
130: Obstet.
119, 1970. 2. Stone, O.J., and
Mullins, J. F.: Chronic paronychia in children. Clin. Pediatr. 7: 104, 1968. 3. Barlow, A. J. E., et al.: Chronic paronychia. Br. J. Dermatol. 82: 448, 1970.
247 Downloaded from cpj.sagepub.com at UNIV OF WESTERN ONTARIO on March 26, 2015
Paronychia of
the Great Toe of Infants
Susannah Walker, M.D.
Ull~II~SL,a’I’~h’S
of stretchable material are currently popular apparel for infants under six months of age. As these are made c~~~ stretchable material, some mothers continue to dress their children in these garments even though the size is too small for the infant. Recently the author cared for a patient with a paronychia of the great toe caused by a poorly fitting undersized infant jumpsuit. Case
Report
A twe~-month-c~lcl white male presented with soft tissue swe!!ing, redness and crusted yellow drainage around the nailbed of his right great toe. He was afebrile. The jumpsuit he was wearing was stretched tightly over both of his great toes. Further questioning of the mother indicated that she had been dressing him in yjumpsuits that had been purchased for him when he was a neonate. Therapy consisted of oxacillin 50 mg/kg/day and avoidance oF jumpsuits; resolution of the paronychia occurred in five days.
possibly fc~~al ischemia enhancing the development of infection after minor trauma. The antibiotic treatment chosen for therapy of the paronychia was based upon the fact that penicillin-resistant Stc~phyh~coccr.s’ aureus and CFrcxzc~ ,~# beta hemolytic streptococcus are ~s~zz~monly the cause of paronychia.1 1 usually these primary l~sir~ns are similar tQ soft tissue cellulitis at other sites and are not followed by the development of chronic paronychia, a troublesome condition caused by different etiologic agents.~’~ Mothers should be urged to use only properly fitting jumpsuits. Paronychia of the great toe may occur if the baby is dressed in tion
or
undersized garments.
~~k~~~lee~g~~:~~ The author expresses her appreciation for his interest and review of the
Dodge
Dr. Philip R. manuscript.
to
Comment
The undersized jumpsuit
likely produced primary trauma with subsequent infecFrom The Edward Mallinckrodt
most
Department of Pedi-
atrics, Washington University School of Medicine, and The Division of Ambulatory Pediatrics, St. Louis Children’s
Hospital,
St. Louis,
Missouri.
References 1. Eaton, R. G., and Butsch, D. P.: Antibiotic guidelines for hand infections.
Surg. Gynecol.
130: Obstet.
119, 1970. 2. Stone, O.J., and
Mullins, J. F.: Chronic paronychia in children. Clin. Pediatr. 7: 104, 1968. 3. Barlow, A. J. E., et al.: Chronic paronychia. Br. J. Dermatol. 82: 448, 1970.
247 Downloaded from cpj.sagepub.com at UNIV OF WESTERN ONTARIO on March 26, 2015
