The foot as a primary site for distant metastatic infection.

Localized foot infection can lead to generalized sepsis under certain conditions. Two diabetic patients who suffered from infected foot ulcers, even after treatment with debridement and appropriate antibiotics, developed distant site infection. Another diabetic patient developed a distant site abscess from a chronic foot infection, for which he initially sought no medical treatment. Evaluation revealed that one patient had a psoas muscle abscess, one a renal abscess, and one an epidural abscess. All three patients were treated aggressively for their infections. One recovered fully, while two expired from septic complications associated with their illnesses. These case histories, along with the chronology of the development of sepsis from a foot infection are presented.