# Pulp Space Infection of the Finger or Thumb (Felon) - Category: infectious - Review status: reviewed (every claim checked against a document named on this page) - Sources: Egyptian National Drug Formulary - antimicrobial-2023.pdf, Flucloxacillin monograph (chapter PDF p361) · Nardi NM, McDonald EJ, Syed HA, Schaefer TJ. Felon. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; last update April 30, 2024. - Verified date: 2026-08 ## Verified against - Egyptian National Drug Formulary - antimicrobial-2023.pdf, Flucloxacillin monograph (chapter PDF p361) ## Treatment metadata - Flucloxacillin — oral.solid ## Complete treatment card ```text PULP SPACE INFECTION OF THE FINGER OR THUMB (FELON) Sources: Egyptian National Drug Formulary - antimicrobial-2023.pdf, Flucloxacillin monograph (chapter PDF p361) · Nardi NM, McDonald EJ, Syed HA, Schaefer TJ. Felon. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; last update April 30, 2024. Review status: REVIEWED against the source listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (6) - The complaint is pain and redness of the fingertip [redness] - Injury to the finger may be remembered, but often no cause is found - Typically redness comes first, then swelling and pain follow [redness] - Pain starts mild and quickly becomes severe and throbbing, worse when the hand hangs down - The infection sits inside the closed compartments of the fingertip pulp - Red flag: left long enough it reaches the bone underneath, the joint or the tendons SIGNS - what you find (5) - The fingertip pulp over the end bone is tense, red, and swollen without pitting - Swelling stops at the end bone, held back by the fibrous walls of the pulp - Pressure inside the pulp may burst it open by itself, which eases things only briefly - The tissues feel tense and fluctuant, and the tip is exquisitely tender to touch - Red flag: the tissue around it risks ischaemia once the swelling and the pus compress the blood flow [ischaemia · pus] TESTS (7) - Examining the finger is usually enough to make the diagnosis - Note any bone abnormality and check for signs the tip is losing its blood supply - Image the finger if something may have penetrated it - Imaging can also show a fracture, bone infection or gas in the tissues, pointing elsewhere - Gram stain and culture any discharge, to steer the antibiotic - Biopsy is very rarely needed - Red flag: without prompt incision and drainage together with antibiotics it destroys tissue, spreads into what lies next to it, and makes the patient systemically ill IF NOT THIS - what else fits (9) - Cellulitis of the finger - Dermatomyositis - A fingertip injury - Granuloma annulare - Bruising left by a pulse oximeter probe - Herpetic whitlow - Pyogenic granuloma - Paronychia around the nail fold - Reiter syndrome Source StatPearls "Felon" - disease-level clinical article Status traced to the source above 1. FLUCLOXACILLIN [1st line] Adult 250 mg orally (or by intramuscular injection) four times daily; the dose may be doubled for a severe infection. - As directed (formulary gives no fixed course length for this dose; a short course, e.g. 5-7 days, is typical clinical practice, reviewed against response). Peds Paediatric dosing is specialist-set and is not reproduced here. Source Egyptian National Drug Formulary - antimicrobial-2023.pdf, Flucloxacillin monograph (chapter PDF p361) Why A felon is a closed-space staphylococcal soft-tissue infection, matching flucloxacillin's formulary indication for staphylococcal skin and soft-tissue infections; oral therapy is appropriate for early, non-fluctuant disease. Caution Penicillin allergy is a contraindication - ask about prior reactions before prescribing. A tense, fluctuant felon needs incision and drainage referral; antibiotics alone will not resolve a closed abscess and delay risks pulp necrosis. Spreading redness up the finger or hand suggests tenosynovitis or cellulitis and needs urgent reassessment. Diabetic or immunocompromised patients have a higher risk of rapid spread and a lower threshold for referral. Rare but serious cholestatic jaundice/hepatitis can occur, more often with longer courses and in older patients - warn to stop and seek review if jaundice develops. Egypt FLUMOCIN 250MG 12CAPS. UP PHARMA 6.20 EGP (0.52/unit) -> ! also contains amoxicillin AMOFLUX 125/125MG 12 CAPS. RAMEDA > DELT... 8.25 EGP (0.69/unit) -> ! also contains amoxicillin FLUCAMOX 250MG 12CAPS. SEDICO 8.25 EGP (0.69/unit) -> ! also contains amoxicillin FLUMOCIN 500MG 8 CAPS. UP PHARMA 6.00 EGP (0.75/unit) -> ! also contains amoxicillin CURAFLUX 125/125 MG 12 CAPS. RAMEDA > PIONEER 12.50 EGP (1.04/unit) -> ! also contains amoxicillin AMOFLUX 250/250MG 16 CAPS. RAMEDA > PIONEER 18.00 EGP (1.12/unit) -> ! also contains amoxicillin HI-FLUCIL 250/250MG 16 CAPS. CID 20.00 EGP (1.25/unit) -> ! also contains amoxicillin AMPIFLUX 500 MG 12 CAPS. PHARCO 16.00 EGP (1.33/unit) -> ! also contains ampicillin Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)