Pseudomonas nail infection - Nail and Distal Digit
Alerts and Notices
Synopsis

- Green discoloration of the nail plate
- Paronychia
- Distolateral onycholysis
The main complaint of patients is the green discoloration of the nails. Patients must avoid excessive exposure to moist environments, or they will have a high rate of recolonization even after treatment.
Green nails are more common in hairdressers, dishwashers, food handlers, and health care workers.
Green nail syndrome is rare in children but can be seen in those who are immunosuppressed.
Codes
ICD10CM:A49.8 – Other bacterial infections of unspecified site
SNOMEDCT:
402932005 – Pseudomonas aeruginosa infection of nail
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Differential Diagnosis & Pitfalls
- Subungual hematoma
- Onychomycosis
- Longitudinal melanonychia
- Subungual melanoma
- Chemical exposure to solutions containing pyocyanin or isocyanate
- Yellow nail syndrome
- Paronychia
- Fusarium infection
- Proteus mirabilis infection
- Aspergillus infection
- Favipiravir-induced greenish fluorescence of nails
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Last Reviewed:03/05/2017
Last Updated:02/14/2022
Last Updated:02/14/2022


Overview
Pseudomonas is a common bacteria that likes moist places. These germs can infect any place of your body that is often wet, such as your ears or your fingernails. Nail infection is usually caused by frequently exposing your hands to moisture. Previous injury to a nail, or another nail disease such as psoriasis, may make you more likely to have Pseudomonas nail infection.This infection can occur on your hands or feet. It may only affect 1 or 2 nails, or it may be more widespread.
Pseudomonas nail infection is also called green nail syndrome because of the green discoloration caused by the bacteria.
Who’s At Risk
You're at risk of developing Pseudomonas nail infection if your hands or feet are constantly exposed to moisture, or if you frequently use soaps / detergents.Immunocompromised and elderly individuals are more likely to get Pseudomonas nail infection. It is rare in children.
Signs & Symptoms
Infected nails may be green-black or green-blue. The skin around the nail may be swollen, and the nail may also lift off from your finger or toe.Self-Care Guidelines
Soaking the affected fingers in a vinegar solution may help treat the infection. Dilute 1 part vinegar with 5 parts water and soak for an hour. This can be done twice a day.To help prevent future infections:
- Wear gloves to shield your hands from water and chemicals.
- Keep nails trimmed as short as possible.
When to Seek Medical Care
Contact your doctor if one or more of your nails turns a green color, or your nail is lifting from the nail bed.Treatments
Your doctor may prescribe a topical antibiotic you can apply under the edge of the affected nails.If those measures are ineffective, oral antibiotics may be prescribed to kill the infection.