Nail bed inflammation in the baby

Introduction

Nail bed inflammation (panaritium) is an inflammation of the nail fold, the nail bed and sometimes the surrounding structures. The pathogens of this disease can be bacteria such as streptococci or staphylococci. However, it is also possible that the trigger is fungal or viral infections such as herpes. The pathogens can migrate through tiny tears in the nail fold or nail wall and trigger the inflammation there.

Symptoms

It is important to know at which stage of the disease the symptoms occur. The disease usually begins with an inflammation of the nail walls (paronychia) and then progresses to an inflammation of the nail bed (Panaritium subungunale). In this stage, the pus is well visible under the nail and usually causes pain.

Painfulness under pressure can often be observed here. The affected babies usually cry a lot because of the pain. The affected finger or toe (see: nail bed inflammation on the toe) is also severely reddened and overheated.

If the inflammation is not treated or is suppressed by the babies’ own immune system, the nail bed inflammation can also spread to the superficial layers of skin (panaritium subcutanem). Of course, the disease can also progress further and lead to a lifting of the upper skin layer (epidermis) through blistering, this stage is also called Panaritium cutaneum. It can also occur that the nail bed inflammation does not remain with these superficial forms, but penetrates even deeper into the tissue.

These forms are then the deep forms of nail bed inflammation. On the one hand, the inflammation can spread to the bone (Panaritium ossale), on the other hand there is a risk that the tendons also become inflamed (Panaritium tendinosum). The joints may also be affected if the inflammation has the opportunity to spread unchecked (Panaritium articulare).

In the case of a deep nail bed inflammation, the affected babies have the strongest pain and take a protective position with the affected joints. If deep nail bed inflammation occurs, general inflammation symptoms such as fever, chills and increased fatigue may also develop. It can also cause the nail to change its shape and color and fall off.

Since babies and toddlers do not yet have such a well developed immune system as adults, they can more easily become infected with the pathogens. These can of course spread much better and faster in babies than in adults if their immune system is not as well developed. A nail bed inflammation is a local, i.e. locally limited inflammation of the nail bed.

Fever, on the other hand, is a sign that a systemic inflammation affecting the entire body is taking place. Therefore, fever does not usually occur with nail bed inflammation. If this is nevertheless the case, a pediatrician should be consulted.

This means that the baby is either ill with something else or that the inflammation has spread from the nail bed. Both are situations that should be clarified more precisely. The formation of pus is not a necessary symptom of an inflammation.

This means that an inflammation of the nail bed can also be present when no pus is visible. If pus is present, it should be removed. If pus emerges from the inflamed wound on its own, a little help can be given by gently “squeezing” the area.

However, this should only be done with clean hands and the inflamed area should then be thoroughly disinfected. However, if the skin above the inflammation is clearly swollen and a yellowish discoloration of the area underneath is visible without pus escaping, it is possible that the pus is accumulating under the skin. This pus must be removed by a doctor. For this purpose, a small incision is made to “relieve the focus of the inflammation”, i.e. an exit is created to allow the pus to drain away. It is therefore advisable to consult a physician when pus occurs, who can remove the pus and take a closer look at the inflamed area, also to clarify the cause.