Registered Nurses' Association of Ontario

Signs and Symptoms of Venous Leg Ulcer Infection

  • When a client with an ulcer develops sudden pain, a bacterial infection may be present.
  • An infection may be indicated based on the presence of bacteria/gram tissue.
  • The presence of bacteria in a leg ulcer, however, does not mean that it is infected as all chronic ulcers can be colonized by microorganisms which are not producing any inflammatory reaction.
  • A diagnosis of infection should therefore be made on clinical evidence, e.g., cellulitis.
  • A clinical assessment is recommended if infection is suspected.
  • Signs and symptoms of venous leg ulcer infection:

Increased pain


New areas of wound breakdown


Friable granulation tissue


Foul odour


Increased exudate


Bright red granulation tissue


Bridging of soft tissue and epithelium


Erythema >2cm beyond the border of the wound


Increase in ulcer size


Clinical Management
Assessment and Management of Venous Leg Ulcers
Point of Care Resources