Pseudomonas-Associated Hot Foot or Hot Hand Syndrome

Clinical features of hot foot or hot hand syndrome:

(1) The person has been in water contaminated with Pseudomonas aeruginosa. This may be a hot tub, whirlpool, sauna, wading pool or swimming pool.

(2) The patient develops painful abscesses on the hands and/or feet within 1-3 days that feel hot.

(3) Culture of the abscess isolates Pseudomonas aeruginosa.

(4) Culture of the water sources yields Pseudomonas aeruginosa which is the same strain as that isolated from the abscesses.

(5) No other diagnosis (palmoplantar hidradenitis, other) can explain the findings.

Additional features:

(1) The syndrome may be more common in children and adolescents.

(2) Some patients may develop folliculitis of the trunk or proximal extremities as is seen in hot tub infections.