Angileri, L., Veraldi, S. (2017). Severe Gram-Negative Intertrigo of the Feet. International Journal of Travel Medicine and Global Health, 6(2), 81-83. doi: 10.15171/ijtmgh.2018.15
Luisa Angileri; Stefano Veraldi. "Severe Gram-Negative Intertrigo of the Feet". International Journal of Travel Medicine and Global Health, 6, 2, 2017, 81-83. doi: 10.15171/ijtmgh.2018.15
Angileri, L., Veraldi, S. (2017). 'Severe Gram-Negative Intertrigo of the Feet', International Journal of Travel Medicine and Global Health, 6(2), pp. 81-83. doi: 10.15171/ijtmgh.2018.15
Angileri, L., Veraldi, S. Severe Gram-Negative Intertrigo of the Feet. International Journal of Travel Medicine and Global Health, 2017; 6(2): 81-83. doi: 10.15171/ijtmgh.2018.15
Department of Pathophysiology and Transplantation, Università degli Studi di Milano, I.R.C.C.S. Foundation, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
Receive Date: 11 August 2017,
Revise Date: 31 October 2017,
Accept Date: 09 November 2017
Abstract
Introduction: Intertrigo is a common disease of the skin usually caused by fungi and/or bacteria, often involving major or minor skin folds. Here, we report a case of severe, ulcerative intertrigo of all interdigital folds of both feet caused by Pseudomonas aeruginosa in a patient with type II diabetes who acquired the infection during a trip to Senegal. Case Presentation: Lesions involved all toe-web spaces and the back of the toes and the soles. Ulcers with a purulent-necrotic bed, with some of them covered by brownish-black eschars associated with a greenish, odiferous discharge were recorded. The patient was treated with piperacillin/tazobactam IM for 14 days, achieving complete remission of the infection. In this article, we underline the importance of an early diagnosis and appropriate treatment to achieve healing of bacterial intertrigo without complications. Topical therapy with antiseptics (potassium permanganate, gentian violet solution, hydrogen peroxide) or antibiotics (gentamicin, amikacin) is effective only in early stages of the infection. Systemic antibiotics must be considered in all extensive and severe cases. The choice of antibiotic should be based on the culture and antibiogram results. When this is not possible, wide-spectrum antibiotics that act on both gram-positive and gram-negative bacteria (such as third-generation cephalosporin or quinolone) should be prescribed. Conclusion: The length of treatment should not be less than ten days. In addiction, all patients should be trained to avoid predisposing conditions and adopt preventive measures to reduce the risk of infection.
Amonette RA, Rosenberg EW. Infection of toe webs by gram-negative bacteria. Arch Dermatol. 1973;107(1):71-73. doi:10.1001/archderm.1973.01620160043012.
Leyden JJ. Progression of interdigital infections from simplex to complex. J Am Acad Dermatol. 1993;28(5 Pt 1):S7-S11. doi:10.1016/S0190-9622(09)80301-0.
Westmoreland TA, Ross EV, Yeager JK. Pseudomonas toe web infections. Cutis. 1992;49(3):185-186.
Leyden JJ, Stewart R, Kligman AM. Experimental inoculation of Pseudomonas aeruginosa and Pseudomonas cepacia on human skin. J Soc Cosmetic Chemists. 1980;31:19-28.
Noble WC, Hope YM, Midgley G, et al. Toewebs as a source of gram-negative bacilli. J Hosp Infect. 1986;8(3):248-256. doi:10.1016/0195-6701(86)90120-9.
Aly R, Maibach HI. Aerobic microbial flora of intertrigenous skin. Appl Environ Microbiol. 1977;33(1):97-100.
Eaglstein NF, Marley WM, Marley NF, Rosenberg EW, Hernandez AD. Gram-negative bacterial toe web infection: successful treatment with a new third generation cephalosporin. J Am Acad Dermatol. 1983;8(2):225-228. doi:10.1016/S0190-9622(83)70028-9.
Aste N, Atzori L, Zucca M, Pau M, Biggio P. Gram-negative bacterial toe web infection: a survey of 123 cases from the district of Cagliari, Italy. J Am Acad Dermatol. 2001;45(4):537-541. doi:10.1067/mjd.2001.114747.
Ward CG, Clarkson JG, Taplin D, Polk HC Jr. Wood’s light fluorescence and Pseudomonas burn wound infection. JAMA. 1967;202(11):1039-1040. doi:10.1001/jama.1967.03130240081015.
Silvestre JF, Betlloch MI. Cutaneous manifestations due to Pseudomonas infection. Int J Dermatol. 1999;38(6):419-431. doi:10.1046/j.1365-4362.1999.00606.x.
Janniger CK, Schwartz RA, Szepietowski JC, Reich A. Intertrigo and common secondary skin infections. Am Fam Physician. 2005;72(5):833-838.
Mistiaen P, Poot E, Hickox S, Jochems C, Wagner C. Preventing and treating intertrigo in the large skin folds of adults: a literature overview. Dermatol Nurs. 2004;16(1):43-46.
Top