- In adult, most commonly occurs in distal extremity
- DM and chronic wounds→ GNRs and mixed flora
- Mycobact→ from endemic area and compromised
- Cocci or other fungal→ endemic area and/or compromised
- Assoc w/neuropathy and peripheral arterial dz
- Can also be from traumatic innoculation of bacteria
- Also bacteremia→ more common in kids
- Immuno-compromised
- If from pad/dm→ typically distal ulcer or sinus tract, non-healing, pain
- If traumatic, then suggestive hx, open wound or draining sinus
- Fungal/mycobact→ sub-acute, progressive
- Redness non-healing ulcer
- Visible bone and/or probe to bone→ clinical osteomyelitis