Gram-negative bacterial toe web infection - a systematic review.
T Weidner1, J Tittelbach1, T Illing1
1Department of Dermatology, University Hospital Jena, Jena, Germany.
Summary
Gram-negative bacterial toe web infections (GNBTWI) are challenging to treat, often recurring. This review highlights Pseudomonas aeruginosa as a common pathogen and identifies key risk factors, emphasizing the need for consistent terminology and further research.
Area of Science:
- Dermatology
- Infectious Diseases
- Microbiology
Background:
- Gram-negative bacterial toe web infection (GNBTWI) presents significant clinical challenges.
- High recurrence rates and the frequent need for systemic treatments are common.
- A lack of consistent international terminology hinders communication.
Purpose of the Study:
- To provide an updated overview of pathogens, risk factors, and treatments for GNBTWI.
- To gather evidence-based data on GNBTWI.
- To promote consistent international terminology for bacterial toe web diseases.
Main Methods:
- Systematic review of PubMed-searched articles (1980-2016).
- Inclusion criteria focused on treatment and outcome data.
- Analysis of seven relevant English and German articles.
Main Results:
- Pseudomonas aeruginosa is the most frequently identified pathogen, often in mixed infections.
- Predisposing factors include interdigital tinea, occlusion, humidity, and prior self-medication.
- Debridement of lesions showed positive responses in limited cases.
Conclusions:
- Bacteriological workup with antibiograms is crucial for effective therapy.
- Autosensitization dermatitis and recurrences are common complications.
- More randomized controlled trials are needed for evidence-based GNBTWI treatment strategies.
