Infection Versus Inflammation


How do I know if I'm developing an infection?

We'll begin this discussion by mentioning that while there are some typical presentations of infection, some patients may demonstrate fewer indications of infection than others.  For example, those taking steroids, those with poor immune systems (such as with AIDS patients, the sick, the elderly), those who are taking antibiotics for long periods of time, and other groups may demonstrate a diminished response than most patients.   

In the majority of generally healthy people, however, infected areas of the body will exhibit the five typical signs of inflammation:

  • redness (rubor)  This is also known as erythema
  • increased temperature (calor)
  • swelling (tumor)
  • pain (dolor)
  • diminished function (functio laesa)

To differentiate an infection from simple inflammation, though, you can keep on the look out for the following signs that are more specific for infection:

  • If the redness you see seems to be advancing up the foot or leg, it is likely ascending cellulitis, and a sign of infection that requires immediate treatment.
  • If there is an open wound, there may be some weeping or discharge coming from it.  This discharge could be fluid with mostly proteins in it (serous fluid) or pus (white blood cells with bacteria).   Any discharge coming from a wound should be sent to a laboratory for a culture.
  • Often times there is a bad smell coming from the wound.
  • Tissue cultures will often demonstrate the bacteria present in a wound.  
  • Blood work may show an increased number of white blood cells--the kind of cells that fight off infection.  (See picture below:) 

In the picture to the right is a sample of blood taken from a patient with a suspected infection.   In this example, there are an increased number of white blood cells (stained blue to be readily seen) relative to the red blood cells.

The presence of bacteria in the blood stream is known as "bacteremia", and when the infection worsens, the patient will often experience symptoms of the infection throughout the entire body, a condition known as "sepsis". 

Signs of infection at this stage include:

  • Increased Pain
  • GI distress
  • Tiredness (Malaise)
  • Muscle Aches
  • Headache
  • Fever
  • Night Sweats
  • Shivering
If you're worried about a possible infection, start by watching the wound, paying attention to what your body is feeling, and by taking your temperature regularly.  

At the first signs of a foot infection, contact your podiatrist, family physician, walk-in-clinic, or in severe cases, the local hospital emergency room, so that you can begin antibiotics immediately. 

For more information about infections, try these web pages:

Bacterial, Viral and Fungal Infections
Infections of Bone
Infections of Joint








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The Achilles Foot Health Centre
S. A. Schumacher, D.P.M., F.A.C.F.A.S., F.A.C.F.A.O.M.  
Dr. S. A. Schumacher, Podiatric Corporation  

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