Answer:
Pasturella hand infections: cat bites are frequently a series of benign-appearing puncture marks that are difficult to irrigate. Pasteurella multocida exists in cat and dog saliva, and may produce a rapidly progressive, painful cellulitis. Once infection has developed, patients need to be admitted for IV antibiotics, immobilization, and elevation.
Vibrio: Vibrio are gram-negative facultative anaerobic rods found in the marine environment. Minor hand injuries with fish bones or shells can rapidly progress to cellulitis, thrombophlebitis, and vasculitis that lead to intense swelling and necrosis and rapid onset of septic shock. Vigorous early surgical debridement and fasciotomy to relieve vascular compression is recommended. Vibrio is sensitive to cephalothin, chloramphenicol, tetracycline, and aminoglycosides (From McCarthy).
Herpetic whitlow: caused by herpes simplex virus and commonly seen in medical and dental assistants as well as in the immunocompromised. The lesion is commonly confused with a paronychia or felon. Unfortunately, incision of the lesion may lead to secondary infection and a prolonged recovery. The lesion is characteristic and appears as an erythematous, painful lesion with tiny vesicles at the periphery which are diagnostic. A Tzanck smear confirms the diagnosis. Treatment is nonoperative, and the lesion is self-limiting in 3-4 weeks. Acyclovir may provide some symptomatic relief and decrease recovery time.
Mycobacteria marinum: an atypical mycobacterial infection caused by M. marinum, results from penetrating injuries in a marine environment.
Aeromonas hydrophilia: this organism is found in stagnant water. It can cause an aggressive infection with fatal septicemia. Also associated with leech use for congested flaps. Treatment includes drainage and IV aminoglycosides.
Eikenella corrodans: associated with human bites, best treated with IV penicillin.