The patient is a 40 year old male with a past medical history of type 2 diabetes mellitus with significant neuropathy and hypertension with a past surgical history of right metatarsal osteomyelitis. He presents to hospital with fever, right ear pain, headache, two episodes of diarrhea and redness and blistering to the right 3 rd metatarsal. Upon examination he was noted to have a 1 cm ulceration on the right 3 rd toe on the dorsal aspect associated with redness and edema. He was therefore assessed as having diabetic foot ulcer with possible osteomyelitis for which blood cultures were performed. Gram stains performed on the positive blood culture broth showed gram negative rods Image 1. In our institution initial positive blood cultures are tested by the Verigene System Luminex Corp.
Diabetic Foot Care: Case Studies in Clinical Management
Pitfalls of Intralesional Ozone Injection in Diabetic Foot Ulcers: A Case Study
While gram-positive cocci—particularly staphylococci and streptococci—are the most common causes of mild-to-moderate infections, mixed gram-positive cocci and gram-negative bacilli with or without anaerobic organisms tend to cause chronic infections. Mild infections should be treated on an outpatient basis with oral antibiotics directed against staphylococci and streptococci, and severe infections should be treated initially with broad-spectrum parenteral antibiotics on an inpatient basis, followed by oral antibiotics when possible. Pharmacists play an important role in educating health care professionals and patients about the proper treatment and prevention of diabetic foot infections. Foot infection, a common and serious complication of diabetes, increases the risk of hospitalization, amputation, and death. According to the CDC, Although any wound, ulcer, or traumatic injury involving the foot may lead to infection, certain factors increase the risk at least twofold. Although DFIs can develop in the absence of an ulcer or traumatic injury, most cases begin with a wound.
Case Report: Diabetic Foot Ulcer Infection Treated with Topical Compounded Medications
The Southern District Health Board clinic has a diabetes nurse specialist, herself, a vascular surgeon, orthopaedic surgeon, a podiatrist and the orthotics team offering a holistic approach to patient-centred care, including optimising diabetes control, effective wound care and infection control, pressure-relieving techniques and ensuring adequate blood flow to the limb. Aburn believes that if people, when first diagnosed with diabetes, could see the potential impacts on their feet of diabetes complications like neuropathy and peripheral vascular disease, then health professionals may see a lot fewer diabetic foot or lower leg ulcers. She is a strong supporter of nurses providing quality foot care education right from the outset of diabetes diagnosis and regular foot screening thereafter — annual screening for the low risk and more frequently for those with poorly controlled diabetes, loss of sensation and other risk factors.
Metrics details. Ertapenem is a once-daily broad spectrum carbapenem that is increasingly used to treat polymicrobial osteomyelitis due to diabetic foot and traumatic wound infections. However, limited data exists on ertapenem use for osteomyelitis.