Microbiology and Outcomes of Pedal Abscesses with No Wounds

Objective: There is very little published concerning pedal infections without associated wounds in adults. The objective is to report the microbiology and outcomes of a cohort of 16 patients admitted for pedal abscess with no wound.

Methods: We retrospectively evaluated 16 adults; symptoms, subject demographics, labs, bacterial culture growth and outcomes were collected. Patients lost to follow up were counted as failures. Statistics performed with t test and fisher exact test.

Results: Study included 13 males (81.3%) and 7 subjects with diabetes (43.8%). Subjects presented to hospital 6.4±3.7 days after initial pedal symptoms. Fifteen (93.8%) patients had surgery 1.9±1.1 days after admission. Deep tissue cultures showed single organismal growth with no polymicrobial infections. Four patients had Staphylococcus aureus (25%), 2 had MRSA (12.5%), 5 Streptococcus species (31.3%), 1 E. coli (6.3%), 3 no growth (18.8%) and 1 specimen was not cultured. Ten healed (62.5%) in a mean time of 93.9±85.2 days; 3 were lost to follow up, 1 did not heal, 1 resulted in BKA and 1 died during their admission. There was not a difference in the incidence of healing based on how soon patients sought medical treatment after symptom onset.

Conclusion: Patients with pedal abscess and no wounds have single-pathogen infections, predominantly Staphylococcus and Streptococcus. Neuropathy was identified as a high risk factor for non-healing infections.