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Mouth in Foot Disease
Katie S Melton1, Daniel C DeRosa1, Willie A Agee1
1Department of Medicine, Tripler Army Medical Center, Honolulu HI (KSM, VLP).
Summary
Toothpick injuries can lead to serious infections like cellulitis and abscesses, particularly in diabetics. Early recognition and appropriate antibiotics targeting Eikenella corrodens are crucial for effective treatment.
Area of Science:
- Infectious Diseases
- Bacteriology
- Podiatry
Background:
- Toothpicks, common yet innocuous, can cause severe infections when ingested or embedded.
- Eikenella corrodens, a bacterium from oral flora, is associated with puncture wound infections.
Observation:
- An elderly diabetic patient developed foot cellulitis and abscess after a toothpick injury.
- The infection was unresponsive to initial empiric antibiotics.
Findings:
- Wound cultures revealed Eikenella corrodens and Peptostreptococcus species.
- Eikenella corrodens exhibits resistance to common antibiotics including cephalosporins, macrolides, aminoglycosides, clindamycin, and metronidazole.
Implications:
- This case underscores the importance of considering Eikenella corrodens in soft tissue infections following toothpick injuries.
- Tailoring antibiotic therapy based on injury mechanism and pathogen susceptibility is vital.
- Protective footwear is essential for diabetic patients to prevent such insidious infections.
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