When It’s Urgent
Spreading redness, warmth, swelling, drainage, fever, or red streaking up the foot or leg - particularly in a patient with diabetes, peripheral arterial disease, or immune compromise - is a same-day evaluation. Forefoot infections track quickly along tendon sheaths and into deeper tissues.
Evaluation
A thorough exam, cultures of any drainage, imaging when osteomyelitis is suspected, and prompt initiation of empiric antibiotics with later targeting based on culture results.
Treatment
Most superficial abscesses respond to incision and drainage and oral antibiotics. Deeper infections, infections involving tendon, bone, or joint, or infections in immunocompromised patients require operative debridement and intravenous antibiotics. Limb salvage planning begins early in selected high-risk patients.