52-year-old laborer presents with swelling to his right middle finger two days after sustaining a puncture wound with a piece of metal.  His vitals are stable and he is afebrile.  His physical exam is unremarkable with the exception of fusiform swelling and erythema of the digit.  There is no evidence of lymphangitis or clinical evidence of an abscess.  You perform an ultrasound and note the following...

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