Herpetic whitlow with bacterial abscess.

The herpetic whitlow should be treated nonoperatively. However, a difficult therapeutic dilemma occurs when a whitlow is seen with an established bacterial abscess. We report a case of an adult whose first herpetic whitlow was complicated by secondary periungual abscesses that progressed despite intravenous antimicrobial therapy. Surgical drainage of these periungual abscesses was successfully done in conjunction with intravenous acyclovir with no adverse effects.