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Mixed toe web infection in Adult
Other Resources UpToDate PubMed

Mixed toe web infection in Adult

Contributors: Rajini Murthy MD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

A mixed toe web infection is an infection between the toes that is caused by a primary fungal infection and worsened by secondary bacterial superinfection.

The primary event in these infections is damage to the stratum corneum by dermatophytes. This is superseded by bacterial proliferation and secondary infection. The superinfection is commonly caused by the organisms, which are present even on normal skin, such as Staphylococcus aureus, Staphylococcus epidermidis, aerobic diphtheroids, Enterococcus faecalis, Acinetobacter, Klebsiella, Proteus, and Pseudomonas. Pseudomonas is the most commonly identified organism in gram-negative toe web infection, either alone or within a mixed gram-negative infection.

Bacteria and fungi are more likely to grow in warm, moist environments. Therefore, hot weather, excess sweating, athletic / recreational activities, and closed-toe / tight-fitting shoes can lead to mixed toe web infections, which can appear similar to Candida toe web infections, known as erosio interdigitalis blastomycetica.

Diabetes and smoking are predisposing risk factors for the development of mixed toe web infections.

These infections can be disabling, with the threat of cellulitis or septicemia in immunocompromised individuals, if not adequately treated.

Codes

ICD10CM:
B96.89 – Other specified bacterial agents as the cause of diseases classified elsewhere

SNOMEDCT:
402933000 – Gram-negative infection of toe web

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Last Reviewed:05/02/2021
Last Updated:06/06/2021
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Patient Information for Mixed toe web infection in Adult
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Mixed toe web infection in Adult
A medical illustration showing key findings of Mixed toe web infection : Macerated skin, Web spaces of toes, White scaly plaque, Pruritus
Clinical image of Mixed toe web infection - imageId=4195633. Click to open in gallery.  caption: 'Macerated scale in the third and fourth webspaces that extends to the base of the fourth toe, with surrounding hyperkeratotic scale.'
Macerated scale in the third and fourth webspaces that extends to the base of the fourth toe, with surrounding hyperkeratotic scale.
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