Stepping on a nail can be one of the most detrimental injuries that one can incur to their foot. There is bacteria on our shoes that can be driven into the foot which can lead to severe deep space infections. If left untreated this can progress to a bone infection which would require six weeks of IV antibiotic therapy or possible amputation.
Here is an example of person who stepped on a nail that was protruding through a wooden board. After several days they presented with severe pain in the heel with redness and swelling. The patient was admitted to the hospital, started on IV antibiotics, and taken to the OR for incision and drainage of the infection.
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