The patient is a 75-year-old retired white male with a 3-day history of a papular abscess on and cellulitis of the ulnar aspect of the fifth digit on the right hand. He had presented to the emergency department (ED) and was referred to orthopedic surgery for consultation. At the consultation, the patient reported increased redness, streaking, and moderate pain associated with the papule. He denied nausea, vomiting, diarrhea, vertigo, diaphoresis, dyspnea, fever, or chills. He also denied any neuropathy of the affected hand or any use of topical or oral medications for the current problem. The patient stated he was unaware of any recent trauma to the area. On further inquiry, the patient described himself as an avid gardener and said that he had been working in the garden. His medical history was significant for hypertension, acid reflux disease, and diet-controlled diabetes mellitus.

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