Hand infection - cellulitis vs flexor tenosynovitis

Gardening puncture wounds introduce aggressive organisms. Superficial localised hand cellulitis is treated with oral antibiotics (amoxicillin-clavulanate). If Kanavel signs (fusiform swelling, flexed posture, tenderness along the sheath, pain on passive extension) are present, it is pyogenic flexor tenosynovitis - admit for IV antibiotics and urgent hand-surgery review.