Herpetic whitlow is a herpes simplex virus type 1 or 2 infection of the fin
gers characterised by erythema and painful, non-purulent vesicles. In child
ren it typically occurs after auto-inoculation from herpes stomatitis, herp
es labialis or genitalis. Occasionally, person-to-person transmission occur
s from family members with herpes labialis. We report a 4-year-old girl wit
h multiple herpetic whitlows secondary to herpetic stomatitis and present a
review of the medical literature based on a systematic MEDLINE search of p
ublished paediatric patients (English, French and German language). Of 42 i
dentified patients, 72% were younger than 2 years, most had endogenous or e
xogenous inoculation of herpes simplex virus type 1 and 65% were initially
misdiagnosed as having "bacterial felon". Recurrences were reported in 23%.
Conclusion: herpetic whitlow should be suspected based on clinical signs.
Specific diagnosis can be made by polymerase chain reaction or culture. The
high rate of misdiagnosed cases indicates that this entity is not sufficie
ntly known. Lesions are self-limited; surgical interventions can be harmful
and should be avoided. Recurrences occur as, frequently as in adults.