When kids are outside playing in their bare feet and step on a nail,
an immediate concern is tetanus. But it turns out that they might be in
even more danger if they were wearing tennis shoes.
“Was he wearing shoes at the time or was he barefoot?” asks
Dr. Mike Ziegler, Children’s Healthcare of Atlanta.
Last night eight-year-old Jacquai stepped on a nail. He recently
had his booster shots, so tetanus is not the issue. “And
it went through the bottom of his shoe and came out the top?” the
Jacquai was wearing tennis shoes. “These shoes will often
grow an organism called pseudomonas, which if it gets into the
tissues and near the bone can actually cause a nasty bone infection
called osteomyelitis,” the doctor explains.
Pseudomonas bacteria grows in moist, warm environments like soil
and sweaty tennis shoes.
The fear is that he’s already showing signs of infection. “The
thing I’m a little bit concerned about is that the toe is
already somewhat swollen,” explains Dr. Ziegler, “and
that there’s already a little bit of milky discharge down
there where the nail went in, so I really want to try to prevent
this from becoming somewhat worse.”
Pseudomonas is very resistant to antibiotics, but there is one
that should work, Cipro. “It’s one of the few antibiotics
that we can give by mouth that will actually help to treat and
deal with a pseudomonas infection,” he tells the family.
Jacquai will go home, but he’s not out of the woods yet. “It’s
very important that parents understand also that the wound may
look clean, there may be no fever, but injury down deep inside
the tissues could be leading to a smoldering infection that can
destroy bone,” warns Dr. Ziegler.
He will need to follow-up with his regular doctor in a few days
to make sure the infection is not getting worse.