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Gram-Negative Toe Web Infection
Aka: Gram-Negative Toe Web Infection, Tinea Pedis Superinfection, Interdigital Intertrigo Secondary Infection, Bacterial Intertrigo of Toe Webspace
- See Also
- Tinea Pedis
- Intertrigo
- Causes
- Gram Negative infections (most common)
- Pseudomonas aeruginosa
- Moraxella
- Alcaligenes
- Acinetobacter
- Erwinia
- Gram Positive infections (part of mixed-infection)
- Group A Beta Hemolytic Streptococcal Cellulitis
- Staphylococcus aureus
- Staphylococcus saprophyticus
- Risk Factors
- Obesity
- Diabetes Mellitus
- Symptoms
- Burning in toe webspace
- Signs
- Initially mild erythema
- Later, marked erythema, maceration, odor
- Pustular discharge from site
- Management
- Consider Debridement
- Consider hospitalization (severe case, comorbidity)
- Antibiotics (cover for Gram Negatives, Pseudomonas)
- Ciprofloxacin 500 mg PO bid for 10 days
- Ceftazidime 500 to 1000 mg IV or IM q8 hours
- Cefotaxime 1 gram IV or IM q12 hours
- Does not cover Pseudomonas
- Amikacin gel 5% applied to area
- Adjunctive measures
- Acetic acid 2-5% (Burrow's Solution)
- Applied to area as warm compress
- References
- Habif (2004) Clinical Dermatology, p. 413
- Janniger (2005) Am Fam Physician 72(5):833-8 [PubMed]