Herpetic whitlow is a herpes simplex virus type 1 or 2 infection of the fingers 
characterised by erythema and painful, non-purulent vesicles. In children it 
typically occurs after auto-inoculation from herpes stomatitis, herpes labialis 
or genitalis. Occasionally, person-to-person transmission occurs from family 
members with herpes labialis. We report a 4-year-old girl with multiple herpetic 
whitlows secondary to herpetic stomatitis and present a review of the medical 
literature based on a systematic MEDLINE search of published paediatric patients 
(English, French and German language). Of 42 identified patients, 72% were 
younger than 2 years, most had endogenous or exogenous 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 sufficiently known. 
Lesions are self-limited; surgical interventions can be harmful and should be 
avoided. Recurrences occur as frequently as in adults.