INTRODUCTION: Whitlow is an infection of a finger or around the fingernails, 
generally caused by bacterium. However, in rare cases, it may also be caused by 
the herpes simplex virus. As herpetic whitlow is not seen often, it may go 
under-recognised or be mistaken for a different kind of infection of the finger. 
Delayed recognition and/or treatment puts patients at risk of complications 
ranging from superinfection to herpetic encephalitis.
CASE PRESENTATION: A 23-year-old Caucasian man with no medical history was 
referred by his primary care physician because of erythema and swelling of the 
little finger of his left hand. The primary care physician had already treated 
him with the oral antibiotic Augmentin® (amoxicillin-clavulanic acid) and 
incision of the finger, but this had not resolved his complaints. He had 
multiple vesicles on the finger, which led to the diagnosis of herpetic whitlow, 
which we confirmed by polymerase chain reaction testing. All cutaneous 
abnormalities disappeared after treatment.
CONCLUSIONS: Whitlow is rarely caused by the herpes simplex virus, but this 
disease requires a swift recognition and treatment to prevent complications. 
This case serves to emphasise that not all whitlow is caused by a bacterial 
infection, and that it is important to differentiate between herpetic and 
bacterial whitlow, as these diseases require a different treatment.