Abstract
Introduction Herpetic whitlows in infants are rare. Previous authors only reported individual
case reports. We present a case series of six infants.
Materials and Methods This is a retrospective study of six cases of herpetic whitlows in infants seen by
the senior author (MMA) over the past 23 years (1995–2017 inclusive). The following
data were collected: age, sex, digit involved in the hand, mode of transmission, time
of presentation to the author, clinical appearance, presence of secondary bacterial
infection, presence of other lesions outside the hand, method of diagnosis, treatment,
and outcome.
Results All six infants initially presented with classic multiple vesicles of the digital
pulp. In all cases, there was a history of active herpes labialis in the mother. Incision
and drainage or deroofing of the vesicles (for diagnostic purposes) resulted in secondary
bacterial infection.
Conclusion The current report is the first series in the literature on herpetic whitlows in
infants. We stress on the mode of transmission (from the mother) and establishing
the diagnosis clinically. In these cases, no need for obtaining viral cultures or
polymerase chain reaction; and no medications are required. Once the vesicles are
disrupted, secondary bacterial infection is frequent and a combination of oral acyclovir
and intravenous antibiotics will be required.
Keywords
herpes simplex - herpetic whitlow - hand - infants
