Brief Answer:
Line of Management and possibilities of the likely infections in hand.

Detailed Answer:
Welcome to Health Care Magic.

Thanks for writing.

I am Dr. Saddiq ul Abidin. I have read your question completely, I understand your concern and will try to help you in best way possible.

First of all, it is so sad to hear about your mother. Hope she is well on course, towards the restoration of her previous physical activity status gradually with all the supportive means and excellent nursing care, by her immediate care takers including you, as is evident, by the kind of concerns, you have shown regarding her health. A good nursing care, and the keen interest of immediate relatives, is the hall marks of the treatment after a stroke and associated disabilities.

Now, as far as the swilling in the finger is concerned, and the kind of description you have shared, the likelihood of a soft tissue infection, like cellulitis is quite high, as the presence of pain and tenderness along with swelling raises its possibility.

Other possibilities of such an acute swelling can be, due to local accumulation of tissue fluid or lymph or spillage or vascular fluid out of the blood vessels, in case of any obstruction to venous or lymphatic system in that area. But that in most cases, is painless, however, can be associated with pain due to compression of nerves and associated structures.

It would have been more appreciable if we had known whether she developed any fever or other associated symptoms along with it or not,and whether there is any signs of a pointed focus of infection, like a boil or an ulcer there or not, as such signs may reflect presence of follicular infections, or infected etiologies like boils caused by certain bacteria like staph. aureus etc.

The kind of symptom which you have raised the concern about, regarding spread of the pain, through out hand and arm, is reflecting likelihood of nerve compression or involvement as in such condition, pain can be experienced in all the areas supplied by that nerve.

Final verdict can be given after a careful examination and workup like complete blood picture and ultrasound, with or without doppler studies, to confirm nature of swelling and any underlying deeper involvement.

The supportive management, would range from warm compressions to mild analgesia, like with acetaminophen, and incision and drainage if the collection of puss is proven. In case of cellulitis, certain antibiotics to cover the gram positive bacteria like penicillin, third generation cephalosporins, vancomycin or linezolid. But it would be advisable for you to discus all these options with your GP or arrange appointment with a general surgeon and a dermatologist.

I hope this answered your question. If you have more queries I am happy to answer. Otherwise rate before closing the discussion.

You can also contact me directly through: http://doctor.healthcaremagic.com/doctors/dr-saddiq-ulabidin/70164

Hoping her a speedy recovery.

Regrads.

Dr. Saddiq ul Abidin

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Brief Answer:
clarification of certain queries.

Detailed Answer:
Thanks for sharing the details.

The presence of pain and swelling does indicate inflammation which can be infective or autoimmune in the case of your mother.

What I couldn't understand was, the pain in hands and arms which you were mentioning earlier, is it on same side or on both sides? Because this fact will have strong impact on the diagnosis.

Presence of pain on one side actually favors monoaryhritis or swelling of small joints on one side as well as does point towards infective whether of small joints or other small tissue. That needs a carefull assessment with an orthopedic or surgical specialist to assess for the reason of swelling, including joints and the soft tissue infections, like you mentioned about presence of that mark.

If pain is on both sides, it may need detailed evaluation by a rheumatologist to look for other autoimmune causes. Also a series of blood tests like complete blood count, uric acid, CRP, ESR, RA factor may be needed. Also the radio graphs or ultrasounds may help establish some diagnosis.

Steroids have anti inflammatory actions and just can temporarily reverse the infections, but for autoimmune conditions these can be prescribed for longer times but in bed bound or patients with such premorbids, it's not advisable to jump to steroids without having a clear evidence as it will make them prone to infections by suppressing the already compromised immunity levels.

Wishing her a speedy recovery. Kindly rate before closing the discussion. In case of regular inquiries, you are always welcome. Keep me apprised of the reports. Regards.

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