There's a story doing the rounds of what appears to be a rather unfortunate visit to a fish spa. It seems that the person in question contracted a bone infection in her toes after standing on broken glass back in 2006, which led to half her big toe being amputated. After going for a fish pedicure in Thailand in 2010, she then contracted another infection that has led to all the toes on her right foot being amputated.

After suffering from fever and sickness when she got home, she was diagnosed with osteomyelitis, a painful bone infection. (Some outlets report she suffered from something called schwelmenella, we think they mean shewanella?). The suspicion was that it was contracted through the water via her pre-existing surgery wounds. 

Details of the story are unclear, as it appears to be based on the person’s Instagram account, @terrifically-toeless, which is currently set to private, thus the story and its specifics are impossible to verify at present. So, should we be scared?

According to the Mayo Clinic, osteomyelitis is most often caused by the common Staphylococcus bacteria, which can enter your body through open wounds, infected tissue, or the bloodstream. Bones are normally infection resistant, so in order to get this condition, recent bone surgery, damaged circulation, or immunodeficiency is required.

So, if there was opportunistic bacteria in the fish tank where this person got their pedicure, it’s certainly possible that's where she got the affliction. 

This isn’t the first time a story like this has cropped up. A recent JAMA Dermatology report described how another pedicure client appeared to suffer from onychomadesis – wherein interrupted nail growth results in the separation of the nail plate from the nail matrix – six months post-procedure.

The patient denied that she had suffered from any pre-existing conditions that may have given rise to her toenail’s grisly fate. The only thing that her condition could be speculatively linked to was her fish pedicure.

It appears that there are several possibilities as to what triggers onychomadesis, and how it progresses, but such mechanisms remain unclear. At the time, experts not involved in the case study report were skeptical of the association made too, so nothing definitive can be said.

This latest story is a little different, though, as it involves waterborne infections from unsterilized water.

The UK’s National Health Service (NHS) points out, in a gloriously pun-heavy post, plenty of scary-sounding stories about fish pedicures are often unsubstantiated, and the risks are usually overblown.

The post was a response to a story that appeared in a newspaper warning that fish pedicures could spread HIV and Hepatitis. It turned out that this wasn’t based on an incident that actually happened, but a possibility featured in a health report. Although such infection risks can’t be said to be zero, the report nonetheless said such an outcome’s likelihood was “extremely low.”

You can theoretically catch an infection while having a pedicure. Blood-borne infections like these two mentioned were thought to be highly improbable, as Garra rufa fish don’t seem to draw blood. You could potentially get a bacterial or fungal infection, but this isn’t unique to fish spas, and the risk for a healthy person is still very low.

Is the latest story about a potential infection valid, then? Sure, it’s possible, but the right conditions were there to make such a rare occurrence happen.

If you’re worried, but you really can’t resist the urge to dip your feet in the waters, the NHS and that report recommended that you follow a few simple rules. Don’t do it with open cuts or sores on your lower legs, if you already have an infection or some kind on the feet or within your blood, have an immune deficiency, or have bleeding disorders.