Infections of the Foot, Ankle and Leg

There are various agents that can cause infections. The most common form of infections are caused by bacteria, mainly Streptococcus and Staphylococcus. This type of infection generally comes about when there is a cut in the skin for the bacteria to enter (puncture, laceration, abrasion, etc.), but it can also occur without an opening. It can come from your bloodstream or joint. So, if you have any implants or pacemakers, you may be susceptible to an infection spreading to another site. You can get redness, warmth, and swelling in the area, which can then travel up the leg. This increased redness and swelling is known as cellulitis. An infection can cause puss to accumulate in a localized area and this is known as an abscess. Sometimes the infection can penetrate deeper and lead to a bone
cellulitis-foot infection, known as osteomyelitis. Other types of infections can be caused by viruses, which lead to warts, and fungus. If fungus is the culprit then it can lead to athlete’s foot and fungal nails. Sometimes one infectious agent can lead to another. For example, someone with a fungal infection of the foot (athlete’s foot) can have microscopic tears in the skin which can in turn lead to a bacterial infection with cellulitis. Diabetic patients need to be extra cautious because infections that might be minor in a healthy patient can cause prolonged healing, complications, and deeper infections. All of these infections can be life threatening to any patient if they are not treated correctly and in a timely fashion.

What to look for in an infection?

Any temperature change or change in skin coloration can be a sign of an infection. Streaking, redness, warmth, swelling, fluctuant skin, blisters, fevers, chills, nausea, or vomiting should be paid careful attention to and will require immediate attention from your doctor.

How to treat an infection?
Immediately visit your doctor if you think you have an infection or any openings in your skin. Treatment options can range depending on what type of infection you have. If you have a wart, there are many ways to treat it, including but not limited to freezing, burning, excising, or using prescription creams to get rid of them. Fungal infections can be treated with topical medications, oral medications, or laser therapy. Bacterial infections that are superficial can generally be treated by topical and/or oral antibiotics. If the cellulitis becomes deeper, IV antibiotics may be required. If an abscess is present, a surgical procedure may be required to drain the pus from the site in conjunction with antibiotics. Bone infections can become complicated. Sometimes they are treated with antibiotics and depending on the case, surgical intervention may be required. Diagnostic imaging, such as x-rays, bone scans, and MRIs may be used to see the depth of the infection. Blood work and cultures may be performed as well to test for an infection.

How do infections affect diabetic patients?
A diabetic patient should be extra cautious with any skin changes noted. Typical lesions, such as corns and calluses could ulcerate beneath the skin in a diabetic patient and be a portal for infection or non-healing wound. Infections take a lot longer to heal in diabetic patients than a healthy individual and delay in healing could cause the infection to spread deeper. This may result in a deep soft tissue or bone infection very rapidly.

Gout
Some people confuse gout with an infection. Gout is actually an increase in uric acid level in the body. It mimics an infection in that it causes the area to be red, swollen, and extremely painful to the touch. Treatment options for gout are much different than treatment for an infection.

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