The pseudomonas hot-foot syndrome

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.

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.