0521779407-17 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:18
1140 Paronychia Parvovirus B19■Consider the need for incision and drainage of the area.
■Assess the need for systemic therapy vs. local therapy.
specific therapy
■Acute Paronychia
➣consider incision and drainage
➣Antibiotics – cephalexin, erythromycin or dicloxacillin
■Chronic paronychia
➣Drying maneuvers
➣Avoidance of trauma
➣Topical antifungal cream (e.g., clotrimazole) may be combined
with a mild corticosteroid (e.g., triamcinolone) cream.follow-up
During Treatment
■Re-evaluate patient 1–2 weeks after initiating therapy
complications and prognosis
■Nail dystrophy may occur.PARVOVIRUS B19
CAROL A. GLASER, MD
history & physical
History
■Parvovirus B19 is a small single-stranded DNA virus.
■Humans only known hosts, not related to canine or feline parvovirus
■Mode of spread: respiratory secretions, blood transfusions
■Incubation period: usually 4–24 days (may be up to 21 days)
■Focal outbreaks elementary, community epidemics
■Winter/Spring
■50% of adults are immune.
■Erythema Infectiosum (EI) aka “fifth disease”Signs & Symptoms
■Classic; Erythema infection (EI) – mild systemic symptoms
➣fever: 15–30%
“distinct rash” (described below)
not infectious at time of rash