Association of Athlete's Foot with Cellulitis of the Lower Extremities: Diagnostic Value of Bacterial Cultures of Ipsilateral Interdigital Space Samples

Abstract

We performed a study to determine how often patients with cellulitis of the lower extremities in the absence of trauma, peripheral vascular disease, or chronic open ulcers have ipsilateral interdigital athlete's foot and whether cultures of samples from the involved interdigital spaces would yield potentially pathogenic bacteria. Athlete's foot was present in 20 (83%) of 24 episodes of cellulitis that were studied. Cultures of samples from the interdigital spaces yielded β-hemolytic streptococci in 17 (85%) of 20 cases, Staphylococcus aureus in 9 (45%) of 20 cases, and gram-negative rods in 7 (35%) of 20 cases. Only /3-hemolytic streptococci were recovered significantly more often from patients than from a group of controls with athlete's foot who did not have cellulitis (P < .01). Athlete's foot may be a common predisposing condition for cellulitis of the lower extremities. In comparison with attempts at microbiological diagnosis such as aspiration and/or biopsy of the area of cellulitis, cultures of samples from the interdigital spaces combined with serial determinations of antistreptolysin titers may offer a simpler noninvasive method of microbiological diagnosis.