Wound Care Library
Patient Education • Clinically Reviewed
Medically reviewed Stephanie Wright, RN, BSN

Signs a Wound Infection Is Getting Worse

Many infections start with subtle changes that are easy to miss. When infection worsens, symptoms become more noticeable and may spread beyond the wound itself. Knowing what to watch for can help you act quickly and prevent serious complications.

Monitor mild redness early after injury
Get evaluated spreading redness or increasing drainage
Urgent care fever, confusion, rapid breathing/heart rate

Early Signs of Wound Infection

Early infections often cause local changes around the wound. They may look mild at first—but usually worsen if untreated.

Redness & swelling

Mild redness can be normal early on, but infection is more likely when redness spreads, darkens/brightens, or swelling increases instead of improving.

  • Redness extends beyond wound edges
  • Warm or tender to the touch
  • Pain increases rather than decreases

Drainage & pus

Some drainage is normal early in healing. It becomes concerning when it thickens, changes color, or increases. Pus is a strong sign of infection.

  • Thick/cloudy drainage
  • Yellow/green/brown color
  • Drainage increases instead of decreases
Tip: A wound that keeps draining without shrinking is often infected.

Advanced Wound Infection Symptoms

As infection worsens, symptoms may extend beyond the wound and indicate deeper or spreading infection.

Increasing pain or tissue breakdown

Pain may feel deeper, sharper, or more constant and may spread beyond the wound area. Skin may darken, blister, or develop dead tissue.

Changes in skin appearance

Watch for purple/gray/black discoloration, shiny/tight skin, blistering, peeling, or rapid worsening changes.

Fever & systemic infection

Fever, chills, weakness, body aches, or nausea can indicate the infection is spreading. In severe cases, infection may enter the bloodstream and lead to sepsis.

Sepsis warning signs: rapid heart rate, fast/labored breathing, confusion, low blood pressure.

How Wound Infections Spread

Infections spread when bacteria move beyond the surface into deeper or surrounding tissue.

Local

Local spread

Expanding redness, warmth, and swelling into nearby skin/tissue. Cellulitis is a common example.

Deep

Deeper tissue involvement

If infection reaches muscle/fascia/bone, healing becomes much harder. Bone infection (osteomyelitis) can require long-term treatment.

Systemic

Systemic spread

Bacteria enter the bloodstream, triggering a dangerous whole-body response that can damage organs and disrupt circulation.

When Infection Becomes Serious

Not every infected wound is an emergency—but some situations require immediate evaluation.

Redness spreads rapidly
Drainage increases or becomes foul-smelling
Fever develops
Pain worsens or becomes severe
Wound stops improving or worsens

Higher-risk individuals

People with diabetes, poor circulation, weakened immune systems, and older adults should seek early evaluation—even for mild symptoms.

Why some infections worsen faster

Deeper wounds, dead tissue, trapped bacteria, and limited circulation (especially legs/feet) can accelerate progression.

Why early treatment matters

Early care can prevent complications. Many infections respond well to timely cleaning, antibiotics, and pressure relief. Delaying care often leads to longer healing and more invasive treatment.

Supporting Healing & Infection Control at Home

Daily habits affect infection risk. Monitoring wounds daily helps catch changes early.

Keep wounds clean and covered
Change dressings as directed
Avoid pressure and friction
Stay hydrated
Eat enough protein and calories
Avoid smoking (nicotine reduces blood flow)

Key Takeaways

  • Early signs include spreading redness, swelling, and drainage changes.
  • Advanced infection can cause skin changes, severe pain, and systemic symptoms.
  • Infections can spread locally, deeply, or systemically.
  • Early evaluation reduces complications and speeds recovery.
Stephanie Wright, RN, BSN

About the Author

Registered Nurse RN, BSN Clinically reviewed

Stephanie Wright, RN, BSN

Stephanie Wright is a registered nurse and health writer with over 15 years of experience spanning bedside care, managed care, utilization review, and population health.

She also has a background in communications, which informs her ability to translate clinical evidence into clear, patient-centered health content. Her work focuses on chronic disease management, prescription medications, preventive care, and healthcare navigation.

Stephanie brings a strong, evidence-based perspective to consumer health writing and is passionate about helping readers understand their options and feel confident advocating for their care.