Hot foot syndrome
Last Updated: 2025-02-11
Author(s): Navarini A.A., Anzengruber F.
ICD11: ED31
Last Updated: 2025-02-11
Author(s): Navarini A.A., Anzengruber F.
ICD11: ED31
Hot foot syndrome has been described in various studies, for example by Fiorillo et al. (2001) and Michl et al. (2012).
Pseudomonas hot foot syndrome.
Hot foot syndrome is a skin infection caused by Pseudomonas aeruginosa. The disease usually manifests itself a few hours to days after walking through water with a high density of pseudomonads, for example in warm outdoor shower basins.
The disease mainly affects children. In a study by Michl et al. (2012), 40 children were affected who showed symptoms within 40 hours of swimming in a pool.
Hot foot syndrome is an independent disease within the group of Pseudomonas infections.
Hot foot syndrome is caused by Pseudomonas aeruginosa, a bacterium that can be found in contaminated water sources such as swimming pools.
Affected children show extensive redness and swelling on the soles of the feet, accompanied by very painful, 1.0-2.0 cm large red nodules and plaques, which are mainly localised in the pressure-loaded areas of the soles. A febrile systemic reaction may occur, but is rather rare.
The diagnosis is based on the clinical symptoms and the temporal relationship of the exposure. In some cases, Pseudomonas aeruginosa can be isolated from skin pustules.
The affected skin areas are mainly the soles of the feet, especially the areas subject to pressure.
The patients usually swam in a pool with a high density of pseudomonads several hours to days before the onset of symptoms.
Histological examination shows neutrophilic infiltration around blood vessels and sweat glands, facultatively with dermal microabscesses.
In some cases, patients may develop a febrile systemic reaction.
Hot foot syndrome is self-limiting and has a good prognosis. The symptoms usually subside within 1 to 14 days.
Prevention consists of complying with hygiene regulations in public pools and regularly checking the water quality.
Avoiding triggers like prolonged standing or hot environments. Wearing comfortable, breathable footwear to minimize irritation.
Topical Treatments: Cooling gels, menthol-based creams, or capsaicin cream may provide local relief.
Pain Management: Nonsteroidal anti-inflammatory drugs (NSAIDs) or analgesics may be prescribed for pain relief.
Corticosteroids: Topical or systemic steroids are often used to reduce inflammation in vasculitis-related cases.
Fiorillo L et al (2001) The pseudomonas hot-foot syndrome. N Engl J Med 345:335-338
Michl RK et al (2012) Outbreak of hot-foot syndrome - caused by Pseudomonas aeruginosa. Klin Padiatr 224:252-255
Zvulunov A et al (2001) Pseudomonas hot-foot syndrome. N Engl J Med 345:1643-1644
Altmeyer P. et al. (2022) Hot-foot syndrome, Altmeyer's Encyclopaedia
