Malodorous discharge, redness, and crusting of the feet
This man was initially treated with antifungals and antibiotics based on his history of tinea pedis. But 2 days later, his condition worsened and he was hospitalized.
A 50-year-old man who worked in construction presented to a local urgent care facility complaining of 2 weeks of bilateral foot discomfort associated with local malodorous discharge, redness, and crusting. He had a past medical history of recurrent tinea pedis and had previously been treated with intravenous (IV) antibiotics for a severe episode of cellulitis. He denied recent fever, trauma, or swelling. Physical examination revealed extensive malodorous crusting of the interdigital webs of both feet, in addition to tenderness, erythema, and serous discharge. He was treated with topical clotrimazole and oral terbinafine for a presumed tinea pedis recurrence; cephalexin and triamcinolone were added a week later after minimal response. Two days later, he sought care at a local emergency department with progressive cellulitis, bullae formation, and extensive desquamation (FIGURES 1A AND 1B) and was hospitalized.
