58-Year-Old Diabetic Man With a Warm, Erythematous Foot

A 58-year-old man with type 1 diabetes mellitus (hemoglobin A1c level, 6.5% [reference range, 4.0%5.6%]) complicated by diabetic nephropathy (chronic kidney disease stage 3A), retinopathy, and severe peripheral neuropathy presented to his local urgent care center with a 24-hour history of right dors...

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Published inMayo Clinic proceedings Vol. 94; no. 3; pp. 526 - 530
Main Authors Higgins, Alexandra, Teixeira, Miguel, Szostek, Jason H.
Format Journal Article
LanguageEnglish
Published England Elsevier Inc 01.03.2019
Frontline Medical Communications Inc
Elsevier Limited
Subjects
Amoxicillin
Amputation
Ankle
Antibiotics
Arthritis
Arthrodesis
Bisphosphonates
Blood
Blood glucose
Bone marrow
Bone surgery
Case studies
Chronic kidney failure
Computed tomography
Cysts
Cytokines
Developmental stages
Diabetes
Diabetes mellitus
Diabetic foot
Diabetic nephropathies
Diabetic nephropathy
Diabetic neuropathy
Diabetic retinopathy
Diabetics
Diagnosis
Edema
Erythema
Fever
Foot diseases
Fractures
Glucose
Glycosylated hemoglobin
Gout
Health aspects
Hemoglobin
Hemoglobins
Infections
Inflammation
Joint diseases
Kidney diseases
Laboratories
Magnetic resonance imaging
Nausea
Osteoclastogenesis
Pain
Patient compliance
Patients
Primary care
Radiography
Surgery
Type 1 diabetes
Ulcers
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Summary:A 58-year-old man with type 1 diabetes mellitus (hemoglobin A1c level, 6.5% [reference range, 4.0%5.6%]) complicated by diabetic nephropathy (chronic kidney disease stage 3A), retinopathy, and severe peripheral neuropathy presented to his local urgent care center with a 24-hour history of right dorsal midfoot erythema and mild pain. Two weeks previously, the patient sustained a right foot injury after falling out of bed. The patient had not experienced fevers, chills, night sweats, nausea, vomiting, or malaise but reported somewhat labile blood sugar levels that day with an afternoon glucose measurement of 170 mg/dL (reference range, 70-140 mg/dL). Further medical history included a distal left second toe amputation secondary to complications from diabetic foot infection, chronic Charcot arthropathy of the right ankle for which he wore a rigid ankle-foot orthosis, hypertension, hyperlipidemia, and osteopenia.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
content type line 23
ObjectType-Report-1
ObjectType-Article-3
ISSN:0025-6196
1942-5546
DOI:10.1016/j.mayocp.2018.04.034