The acutely infected diabetic foot is not adequately evaluated in an inpatient setting

Edelson, Gary W.

doi:10.1001/archinte.156.20.2373

Cited by 47 publications

(19 citation statements)

References 22 publications

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“…Signs of systemic toxicity are surprisingly uncommon in diabetic foot infections [19], even those that are limb threatening. Proper evaluation of a diabetic foot infection requires a methodical approach [20]. Whenever infection is considered, this diagnosis should be pursued aggressively; these infections can worsen quickly, sometimes in a few hours.…”

Section: Diagnosis and Clinical Presentationmentioning

confidence: 99%

“…About half of the patients in reported series have received antibiotic therapy for the foot lesion by the time they present, and up to onethird have had a foot lesion for 11 month. Many patients do not report pain, and more than half, including those with serious infections, do not have a fever, elevated WBC count, or elevated erythrocyte-sedimentation rate [19][20][21].…”

Section: Diagnosis and Clinical Presentationmentioning

confidence: 99%

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Medical Treatment of Diabetic Foot Infections

Lipsky

2004

Clinical Infectious Diseases

142

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Diabetic foot infections frequently cause morbidity, hospitalization, and amputations. Gram-positive cocci, especially staphylococci and also streptococci, are the predominant pathogens. Chronic or previously treated wounds often yield several microbes on culture, including gram-negative bacilli and anaerobes. Optimal culture specimens are wound tissue taken after debridement. Infection of a wound is defined clinically by the presence of purulent discharge or inflammation; systemic signs and symptoms are often lacking. Only infected wounds require antibiotic therapy, and the agents, route, and duration are predicated on the severity of infection. Mild to moderate infections can usually be treated in the outpatient setting with oral agents; severe infections require hospitalization and parenteral therapy. Empirical therapy must cover gram-positive cocci and should be broad spectrum for severe infections. Definitive therapy depends on culture results and the clinical response. Bone infection is particularly difficult to treat and often requires surgery. Several adjuvant agents may be beneficial in some cases.

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Section: Diagnosis and Clinical Presentationmentioning

confidence: 99%

Section: Diagnosis and Clinical Presentationmentioning

confidence: 99%

Medical Treatment of Diabetic Foot Infections

Lipsky

2004

Clinical Infectious Diseases

142

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“…Regrettably, on routine visits of diabetic patients to the primary care physician, foot examinations are performed in only 14% of cases [66], and even patients admitted for diabetic foot complications are almost never adequately evaluated [23,67]. A simple, low-cost educational intervention for physicians and medical staff significantly improved the adherence to foot examination guidelines for patients with diabetes [66].…”

Section: Preventionmentioning

confidence: 99%

Treatment of musculoskeletal infections of the foot in patients with diabetes

Korda¹,

Mezõő²,

Bálint³

2005

Therapy

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The incidence of diabetes, diabetic neuro-vasculopathy and as a result, diabetic foot ulceration is a growing problem all over the world. Diabetic foot ulcers are the most common gateways to foot infection. More than 50% of ulcers will become infected at some stage. The authors review the epidemiology, risk factors, pathophysiology, diagnosis, prevention and treatment of diabetic foot infections, including osteomyelitis. Medical and surgical, local and general treatment -including the empirical and evidence-based use of antibiotics -are thoroughly reviewed.

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“…In the diabetic ulcer the infection develops by spreading from contiguous softtissue to underlying bone. It may involve any bone of the foot, but it mostly affects forefoot bones [22].…”

Section: Osteomyelitis In the Diabetic Footmentioning

confidence: 99%

The diabetic foot: Charcot joint and osteomyelitis

Giurato

Uccioli

2006

Nuclear Medicine Communications

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Foot problems are common causes of disability in diabetic patients with as many as 25% expected to develop severe foot or leg problems during their lifetimes. Although skin ulceration is the most frequent problem, bones may also be involved in two different clinical conditions: osteomyelitis and Charcot osteoarthropathy. Osteomyelitis causes complications in up to one third of diabetic foot infections and is due to direct contamination from a soft-tissue ulcer. Osteoarthropathy Charcot foot is a chronic and progressive disease of the bone and joints. Both osteomyelitis and Charcot joint are conditions with an increased risk of lower limb amputation, both may have a successful outcome when recognized and treated in the early stages. The major diagnostic difficulty is in distinguishing bone infection (osteomyelitis) from non-infectious neuropathic bony disorders as in osteoarthropathy Charcot foot. An additional difficulty is found when a bone infection superimposes a Charcot osteopathy. This condition, which can be clinically suspected when foot ulceration appears in Charcot foot, needs to be diagnosed because it implies a different therapeutic strategy. This article aims to summarize both these two clinical conditions and give indications to make a timely and correct diagnosis.

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The acutely infected diabetic foot is not adequately evaluated in an inpatient setting

Abstract: The results of this study highlight the need for a systematic, detailed lower-extremity examination for every diabetic patient who is admitted to a hospital, particularly those who are admitted with a primary diagnosis that involves a foot complication.

Cited by 47 publications

References 22 publications

Medical Treatment of Diabetic Foot Infections

Medical Treatment of Diabetic Foot Infections

Treatment of musculoskeletal infections of the foot in patients with diabetes

The diabetic foot: Charcot joint and osteomyelitis

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