Toe Infection (ER Story)

3-year-old Jeremiah has a big toe that’s swollen, and it hurts. Dr. Kathleen Nelson says, “What we see here is he’s got an infection. And this yellow stuff in here is pus”. She asks Jeremiah, “Do you bite your toe nails?” He does. And that is probably how his toe got infected. Dr. Nelson says, “Actually, if that foot was in his mouth, there’s a lot of germs in the mouth that can get into broken skin.”

Dr. Nelson says, “We’re going to drain that, which means we are going to open this up a little bit and let the pus come out.” Dr. Teresa Isaias applies some local anesthetic to numb the pain, and makes a small incision. Dr. Isaias says, “Do you see how it’s draining, Mom? That’s the whole purpose is to release that pus.”

Jeremiah will have to take antibiotics for a week. Then the infection should be gone. Dr. Nelson says, “The concern though is that he has to stop biting his toenails, and this is probably easier said than done, because it’s a bad habit.” She says parents should intervene every time a child starts biting his fingers or toes. She says, “There are lots of things that can be done, including rewarding kids when they don’t see them with their hands in their mouths, doing nail checks periodically, putting stars in the chart as the nails increase in size.”

She tells Jeremiah, “Big boys don’t eat their toes”.

Toe infections can develop as the result of germs getting into an injured area on the foot. According to experts at WebMD, be on the lookout for the following signs if you suspect inflammation or infection of the toe, foot or ankle area:

• Increased pain, swelling, redness or warmth around the affected area
• Red streaks extending from the affected area
• Drainage of pus from the area
• Swollen lymph nodes in the groin
• Fever of 100°F (37.78°C) or higher

The feet contain 52 individual bones – that’s 25 percent of the bones in the entire body! There are also muscles, tendons, ligaments, arteries, veins and nerves. It is especially important to ensure your child’s feet are healthy because these bones, muscles and ligaments are still developing and are very susceptible to any external stresses. The Associates in Podiatric Medicine and Foot Surgery have created the following tips to help maintain your child’s healthy feet:

• Do not bind covers over your baby’s feet. It restricts movement and can retard normal development.
• Provide an opportunity for exercising the feet. Lying uncovered enables the baby to kick and perform other related motions that prepare the feet and legs.
• Change baby’s position several times a day. Lying too long in one spot, especially on the stomach, can put excessive strain on the feet and legs.
• Once children begin to walk, their feet should be examined by a podiatrist.
• Check shoe size periodically to ensure that feet have room to grow, and watch for excessive shoe wear in any one area.
• Do not hand down shoes from one child to another. Each pair of feet has its own requirements.
• Walking is the best of all foot exercises. Observe your child’s walking habits. If you see toeing-in or toeing-out, knock knees, or other gait problems, professional attention is needed.
• Night leg cramps are usually due to foot fatigue and muscle imbalance. So-called “growing pains” frequently are symptoms of abnormal foot mechanics.
• Remember that lack of complaint by a youngster is not a reliable sign. The bones of growing feet are so flexible that they can be twisted and distorted without the child being aware.
• Be very careful about employing home remedies against fungus infections or warts on the foot. Strong preparations can burn or otherwise hurt the skin.
• Consult a podiatrist whenever you have questions about your child’s foot health.

WebMD
Associates in Podiatric Medicine and Foot Surgery