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The pseudomonas hot-foot syndrome.

L Fiorillo¹, M Zucker, D Sawyer

¹Division of Dermatology and Cutaneous Science, University of Alberta, Edmonton, Canada.

The New England Journal of Medicine

|August 4, 2001

Summary

A community outbreak of pseudomonas hot-foot syndrome occurred in children who used a wading pool. This condition caused painful plantar nodules due to Pseudomonas aeruginosa in the pool water.

Area of Science:

Dermatology
Pediatrics
Public Health

Background:

A distinct skin eruption affected children's feet after using a community wading pool in 1998.
The outbreak occurred between March and May, impacting children aged 2 to 15 years.

Purpose of the Study:

To investigate the clinical features, cause, and outcome of a specific skin syndrome in children.
To identify the causative agent and contributing factors of the outbreak.

Main Methods:

Retrospective review of medical records for 40 affected children.
Microbiological analysis of pustule cultures and pool water.
Skin biopsy examination for histopathological findings.
Clinical follow-up for up to one year.

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Main Results:

Forty children developed painful erythematous plantar nodules within 40 hours of wading pool use.
Pseudomonas aeruginosa was identified in pool water and a patient's pustules, with identical genetic profiles.
Skin biopsies revealed neutrophilic infiltrate and microabscesses.
Most patients recovered within 14 days with symptomatic treatment; some experienced recurrences.

Conclusions:

The "pseudomonas hot-foot syndrome" is characterized by acute, tender plantar nodules in children.
The outbreak was linked to high concentrations of Pseudomonas aeruginosa in the community wading pool.
The condition has a benign, self-limited course, though recurrences are possible.