Expert: Ronald Levy, M.D. - 4/15/2008

Question
QUESTION: Hello Dr. Levy,  I have had a badly infected finger with swelling, pockets of pus and fever in it for about five days now. Yesterday my husband took me to an new express center which is connected with a hospital here. The physician there ran a needle into my finger about five times and squeezed until only blood was coming out. Then, I was given a tetanus shot and had my finger bandaged.  Today, my finger is swelling up again and more fluid is underneath.  I don't know what to do.  I don't want to go back to the express center.  The doctor there really hurt me and didn't fix my finger.  Is there anything that he could have put on my finger to numb it before he started running the needle inside? I don't know if I should go to a regular doctor or a dermatologist? I just wanted your opinion.   Thanks so much.

ANSWER: You should go to an emergency room ASAP and get the finger drained properly before you get infectious tenosynovitis! The finger needs to be opened and drained. They will do this with a finger block so the procedure shouldn't hurt you (although the block can be painful for a few seconds). The important thing is that this finger is seen by a surgeon. What might look minor now could become much worse if not treated with drainage and antibiotics.

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston

---------- FOLLOW-UP ----------

QUESTION: I just found out that the doctor who worked on my finger is certified in internal medicine.  Should he have even been doing that kind of procedure?  I thought the express  center was sort of like an emergency room that is why we went there. He is the only doctor there and is the one people see when they go there.

Answer
It's not that he can't do it (the procedure itself is relatively easy). The problem is realizing that it needs to be opened. I never heard of an express center but I would think you'd be better off at a real emergency room (or go see a hand surgeon in your area).

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston