Differential Diagnosis for Left Great Toe with Ingrown Toenail Swelling
Single Most Likely Diagnosis
- Paronychia: This is an infection of the skin around the nail, which is likely given the presence of swelling, pus, and the location on the lateral side of the great toe. The expulsion of pus with slight manipulation further supports this diagnosis.
Other Likely Diagnoses
- Ingrown Toenail (Onychocryptosis): While often a precursor to paronychia, an ingrown toenail itself can cause significant pain and swelling, especially if it has been irritated or infected.
- Cellulitis: An infection of the skin and subcutaneous tissues, which could be a complication of an ingrown toenail or paronychia, especially if the infection spreads beyond the nail bed.
- Abscess: A localized collection of pus that can occur in the soft tissue of the toe, which might require drainage. The presence of pus upon manipulation suggests this could be a consideration.
Do Not Miss Diagnoses
- Osteomyelitis: An infection of the bone, which could occur if the infection from an ingrown toenail or paronychia spreads to the bone. This is a serious condition that requires prompt treatment to prevent long-term damage.
- Diabetic Foot Infection: In patients with diabetes, even minor foot infections can quickly become severe. It's crucial to identify and manage these infections early to prevent complications like amputation.
- Deep Vein Thrombosis (DVT): Although less common in the context of toe infections, DVT can occur, especially if there's significant inflammation or infection that affects the veins.
Rare Diagnoses
- Erythromelalgia: A disorder characterized by burning pain, heat, and redness in the hands and feet, which could potentially cause toe swelling, though it's less likely to present with pus.
- Gout or Pseudogout: These are forms of arthritis that can cause sudden, severe joint pain and swelling, which might be considered if the presentation includes significant joint involvement or if the patient has a history of these conditions.
- Malignancy: In rare cases, swelling and infection in the toe could be a sign of an underlying malignancy, such as a squamous cell carcinoma, especially if the condition does not respond to typical treatments for infection.