Can be treated by the emergency physician using incision and drainage followed by antibiotics.
+Is most commonly caused by group A Streptococcus.
+Is the same as a paronychia.
+Requires hospital admission.
+Requires nail bed removal.
A felon is a subcutaneous pyogenic infection of the pulp space of the distal finger or thumb. The patient presents with marked throbbing pain and a red, tense distal pulp space. Staphylococcus aureus is the most common organism, but Streptococcus species, anaerobes, and Gram-negative organisms are also encountered. Most felons can be drained adequately with a limited incision and drainage procedure. Most felons have significant associated cellulitis that should be treated with oral antibiotics. A first-generation cephalosporin or antistaphylococcal penicillin should be prescribed for 7–10 days or until the infection has abated.