Diagnosing Foot Infection in Diabetes

• Published in: Clinical infectious diseases Vol. 39; no. Supplement-2; pp. S83 - S86
• Main Authors: Williams, D. T., Hilton, J. R., Harding, K. G.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.08.2004; University of Chicago Press
• Subjects: Bacteria; Bacterial arthritis and osteitis; Bacterial diseases; Biological and medical sciences; Bones; Diabetes; Diabetes complications; Diabetes mellitus; Diabetes. Impaired glucose tolerance; Diabetic foot; Diabetic Foot - complications; Diabetic Foot - microbiology; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Foot ulcer; Human bacterial diseases; Human viral diseases; Humans; Infections; Infectious diseases; Medical sciences; Osteomyelitis; Osteomyelitis - diagnosis; Osteomyelitis - etiology; Soft Tissue Infections - diagnosis; Soft Tissue Infections - etiology; Ulcers; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Wound Infection - diagnosis; Wound Infection - etiology; Endocrinopathy; Human; Immunopathology; Nervous system diseases; Critically ill; Diabetes mellitus; Diseases of the osteoarticular system; AIDS; Early stage; Peripheral neuropathy; Immune deficiency; Foot; Infection; Symptomatology; Clinical management; Surveillance; Viral disease; Osteitis; Complication; Combined treatment; Peripheral nerve disease; Diagnosis; Disseminated; Immune system
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/383267

Infection represents the presence of an inflammatory response and tissue injury due to the interaction of the host with multiplying bacteria. The disease spectrum is a consequence of the variability in these interactions. Diabetes, because of its effects on the vascular, neurological, and immune systems, can compromise the local and systemic response to infection, potentially masking the typical clinical features and hindering diagnosis. The early recognition of infection, particularly osteomyelitis, is paramount in the management of diabetic foot disease. Careful clinical appraisal remains the cornerstone of the assessment. Hematologic, biochemical, and radiological investigations are important aids in assessing the severity of infection. Microbiological assessment, particularly in more severe infection, requires good-quality samples, combined with rapid transport in an appropriate medium and effective communication with the laboratory. A focused, systematic approach to the accurate diagnosis and treatment of infection, combined with careful monitoring, ensures the maintenance of optimal management.