Question of the Week # 53

A 4-month-old girl is brought by her concerned mother  because the child has been inconsolably crying for 6 hours. The child is breast fed and has been doing well. There is no vomiting, diarrhea, constipation, or increased gas. The mother has not changed her diet and the infant is on no medications. There has been no fever. On physical examination the child is active and screaming. There is no fever.  The physical examination is normal except that there is redness and swelling affecting the left  third toe with indentation proximal to the redness. It is tender to touch. There was no history of similar problems.  The picture is shown below:


The most likely working diagnosis:

A. Trauma

B. Herpetic whitlow

C. Hairy tourniquet syndrome

D. Acute paronychia

E. Ingrown toe nail

F. Acute Gout

The most appropriate next step in management :

A. Joint aspiration

B. X-ray of the foot

C. Inspect the toe for hair strangulation

D. Incision and drainage

E. Topical acyclovir

4 Responses

  1. C and C

  2. C C

  3. ans1:c

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.

%d bloggers like this: