Foot Abscesses With No Accompanying Wound

Clinical Presentation and Pathogens

Amanda L. Killeen, DPM; Katerina Grigoropoulos, DPM; Mehmet Suludere, MD; Peter Andrew Crisologo, DPM; and Lawrence A. Lavery, DPM, MPH

Disclosures

Wounds. 2023;35(7):E236-E239. 

In This Article

Abstract and Introduction

Abstract

Introduction: Acute bacterial infections of the skin and soft tissue are common and often pose serious complications, most commonly caused by Streptococcus species and Staphylococcus aureus.

Objective: The authors report clinical presentation and pathogens in patients with a foot abscess and no wound.

Methods: The authors retrospectively evaluated the demographics, clinical presentation, and microbiology from 20 patient records.

Results: Twenty patients were identified. Fifteen were male (75%), and 10 patients (50%) had DM. Patients presented to the hospital 7.8 ± 4.8 days after onset of symptoms and underwent surgery 2.0 ± 0.9 days from admission. Patients underwent 2.4 ± 1.0 surgeries while admitted. Patients with DM presented with significantly higher erythrocyte sedimentation rate than patients without DM (66.6 ± 46.1 vs 43.3 ± 26.2; P = .02). There were no polymicrobial infections based on deep intraoperative tissue cultures. Seven patients had methicillin-sensitive S aureus (35%), 4 had Streptococcus agalactiae (20%), 3 had methicillin-resistant S aureus (15%), 1 had Streptococcus pyogenes (5%), 1 had Escherichia coli (5%), 1 had Streptococcus dysgalactiae (5%), 1 had an unidentified Streptococcus species (5%), and 2 had no growth (10%).

Conclusion: Patients with foot abscess and no wounds had single-pathogen infections, predominantly Staphylococcus and Streptococcus.

Introduction

Acute bacterial infections of the skin and soft tissue are common and often pose serious complications, most commonly caused by Streptococcus species and Staphylococcus aureus.[1–3] Patients with soft tissue infections comprise 1% to 14% of emergency department visits and 4% to 7% of hospital admissions.[4] An infection incidence rate of 24.6 per 1000 people per year has been reported, with a higher incidence among males and persons aged 45 to 64 years.[5] In adults, foot infections are usually precipitated by a break in the cutaneous skin barrier such as interspace fissures, traumatic penetrating injuries, or ulcerations.[6,7] It is uncommon for foot infection to occur when the integument is intact. Lavery et al[8] reported that only 1 in 150 patients with foot infection did not have some type of wound as part of the presenting concern. The objective of the current study is to report the clinical presentation and pathogens of patients with a foot abscess and no accompanying wound.

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