Q. How to manage painful paronychia in an HIV patient?
Hello doctor,
I think I have an infection in my fingernail. I am HIV positive and have been taking medications. It may be paronychia and is very painful
Hello,
Welcome to icliniq.com.
Please send details of the medications that you were taking and the prescriptions. Besides the picture you shared (attachments removed to protect the patient's identity), what are the discomforting symptoms that you are having at this time? And since when you have the suspected nail infection. Are you having any pus?
I recommend the following:
1. Warm water soaking of the affected finger for 3 to 4 daily until symptoms resolve.
2. Avoid inciting factors such as exposure to moist environments or skin irritants.
3. Keeping the affected lesion dry is essential for proper recovery.
4. Avoid any nail manipulation, such as manicuring, finger sucking, or attempting to incise and drain the lesion.
Investigations to be done:
Local check-up by a hand surgeon
Differential diagnosis:Fungal paronychia
Probable diagnosis:Bacterial paronychia
Treatment plan:Ointment Mupirocin 2% once daily for 15 days
Ointment Clotrimazole 1% once daily for 14 days
Apply both ointments after warm water soaking on the nails.
I also suggest
Tablet Amoxycillin 500 mg and Clavulanate 125 mg one tablet twice daily for five days.
The patient will probably need a prescription from the local physician to source it from the pharmacy. So consult the doctor and take medicine.
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