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In acute paronychia, the causative organisms are usually micro cocci such as Pseudomonas or Proteus sp, and sometimes Candida albicans. Infection extending along the tendon sheaths requires prompt surgical incision and drainage.

Less commonly, as in this case, the plant saprophyte Sporothrix schenckii is the causative organism. Characteristically found on rosebushes, barberry bushes, sphagnum moss, and other mulches, it most often infects farm laborers, gardeners, and horticulturists. The primary lesion, usually on the finger, begins as a small, movable, non tender, subcutaneous nodule that slowly enlarges, adheres to the skin, becomes pink and later necrotic, and finally ulcerates. It responds readily to potassium iodide solution.