Extensive deep soft tissue infection secondary to interdigital tinea

A 43-year-old man with type 2 diabetes of 2 years' duration was admitted via casualty with an infected neuropathic left foot with cellulitis, oedema and a purple patch on the dorsum of the foot. He was apyrexial. The dorsum of his foot was fluctuant and he was taken to theatre and underwent incision and drainage of an abscess. The pus from the abscess grew Staphylococcus aureus and he was treated with flucloxacillin 500 mg qds. The wound was not sutured but left open to heal by secondary intention. The original portal of entry was thought to be a webspace infected with tinea pedis. The foot healed in 9 weeks. He was issued with two pairs of bespoke trainer-style shoes and remained healed.

Key points

• Toe web infections with tinea pedis can be the portal of entry for deep soft tissue infections

• If infected neuropathic feet undergo rapid surgical drainage they heal quickly

• Infected feet with fluctuant areas should undergo surgical drainage as soon as possible to avoid the development of necrosis.

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