Infectious Finger Tenosynovitis

What is Infectious Finger Tenosynovitis

Infectious finger tenosynovitis is an infection of a tendon in a finger and of the layer of tissue that surrounds the tendon (sheath).

Tendons are strong bands of tissue that connect muscles to bones. This condition can quickly damage the tendon and the sheath. The infection can spread to the wrist, arm, and blood.

What are the causes?

This condition is caused by bacteria that get into the tendon and the sheath through a puncture wound. Puncture wounds are commonly caused by a bite or a sharp object, such as a nail.

What increases the risk?

This condition is more likely to be severe in:

  • People who have diabetes.
  • People who use illegal IV drugs.
  • People who have any condition that decreases blood supply to the hand.

What are the signs or symptoms?

Symptoms of this condition include:

  • A curled finger.
  • Pain in a finger when it is straightened.
  • Swelling and tenderness along the length of a finger.
  • Finger redness.
  • Fever.

How is this diagnosed?

This condition may be diagnosed with a physical exam and tests, such as:

  • A culture and sensitivity test. The test is done to determine which type of bacteria is causing the infection. It involves using a needle to remove a sample of pus or fluid from the finger.
  • A blood test. This is done to see if the infection is spreading through the blood.
  • An X-ray of the finger. This is done to see if there is an object inside the finger.

How is this treated?

This condition may be treated with:

  • Antibiotic medicines. Most people get these medicines through an IV tube at a hospital. Once the infection is under control, the medicines may be taken by mouth at home.
  • Surgery. A surgery called incision and drainage may be done to flush out (irrigate) the sheath. You may need this surgery if your infection does not get better within 24 hours or if your treatment did not start within 48 hours of your infection. Sometimes an additional procedure is needed to remove dead tissue or an object (foreign body) from the finger.
  • A splint. You may have to wear a splint on your finger to prevent pain and movement.

This condition is a medical emergency. Treatment must be started as soon as possible to keep the infection from spreading and causing permanent damage. Treatment is usually started in a hospital.

Follow these instructions at home:


  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Take your antibiotic medicine as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

If you have a splint:

  • Wear it as told by your health care provider. Remove it only as told by your health care provider.
  • Loosen the splint if your fingers become numb and tingle, or if they turn cold and blue.
  • If your health care provider approves bathing and showering, cover the splint with a watertight plastic bag to protect it from water. Do not let the splint get wet.
  • Keep the splint clean and dry.
  • Do not put pressure on any part of the splint until it is fully hardened. This may take several hours.

General instructions

  • Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.
  • Perform range-of-motion exercises only as told by your health care provider.
  • Keep all follow-up visits as told by your health care provider. This is important.

Get help right away if:

  • Your symptoms return.
  • Your symptoms get worse.

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