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Pseudomonas hot-foot syndrome
Other Resources UpToDate PubMed

Pseudomonas hot-foot syndrome

Contributors: Naomi So, Susan Burgin MD
Other Resources UpToDate PubMed


Pseudomonas hot-foot syndrome is a skin infection of the soles caused by Pseudomonas aeruginosa. It is characterized by painful erythematous plantar nodules, typically occurring in children following use of Pseudomonas-contaminated pools. Similar involvement of the palms has been reported less frequently. It is clinically distinct from folliculitis caused by Pseudomonas.

This condition typically occurs in young children. It is thought that children may have a thinner epidermis on their palms and soles compared with adults, and also that they may be more active in pool areas; this increases the risk for friction injuries and susceptibility to infection.

Symptoms typically occur 6-48 hours following exposure to contaminated pools and include intense pain followed by swelling, redness, and warmth in the affected areas. Clinical course is usually benign, with rapid resolution. The condition does not typically require antibiotic therapy; however, leukocytosis and low-grade fevers may occur with infection, and antibiotics may be given in more severe cases.

Infections typically occur as outbreaks, with history revealing use of the same contaminated pool or hot tub.


B96.5 – Pseudomonas (aeruginosa) (mallei) (pseudomallei) as the cause of diseases classified elsewhere

11218009 – Infection caused by Pseudomonas aeruginosa

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Pseudomonas folliculitis – follicular papules and pustules
  • Idiopathic recurrent palmoplantar hidradenitis – can be recurrent and typically occur sporadically, without an infectious etiology
  • Pseudomonas suppurative panniculitis – occurs in the setting of sepsis or positive blood cultures
  • Erythema nodosum – tender nodules most commonly found on the anterior shins
  • Pressure urticaria – lesions are often wheals that occur within minutes in cases of immediate pressure urticaria
  • Arthropod bites
  • Trauma

Best Tests

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Last Reviewed:08/20/2018
Last Updated:10/11/2022
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Pseudomonas hot-foot syndrome
A medical illustration showing key findings of Pseudomonas hot-foot syndrome : Skin warm to touch, Sole of foot
Copyright © 2023 VisualDx®. All rights reserved.