Diabetes mellitus (DM) refers to the myriad of diseases which involves a high level of blood glucose over a long period of time. Elevated blood sugar can cause widespread damage to the blood vessels, nerves, eyes and kidneys. Diabetes is capable of decreasing the immune system of the body. If not controlled, it can result in organ impairment. In podiatry, we see a large number of foot problems associated with Diabetes.
Diabetic Foot Infections (DFIs) are a common and severe problem among diabetes sufferers. It should be noted that not all diabetic foot ulcers are infected. However in cases where there are infections, it normally starts as a small ulceration, or calluses, and will invariably grow into bigger ulcers with unabridged polymicrobial infection.
Globally, diabetic foot infections are the most common skeletal and soft-tissue infections in patients with diabetes. They arise from an inadequate blood supply due to microvascular disease and the lack of sensation that results from neuropathy.
Let’s take a look at the different types of Diabetic Foot Infections:
- Superficial Cellulitis
- Deep-Skin and Soft-Tissue Infections
- Acute Osteomyelitis
- Chronic Osteomyelitis
Cellulitis is a common and potentially serious bacterial skin infection. It usually manifests as a red, swollen area that feels hot and also tender to touch. This type of infection is common in the skin of the lower leg and it’s characterized by non-raised skin lesions. The following symptoms are a pointer to cellulitis – swelling, tenderness, redness, blisters, and skin dimpling. An example of cellulitis causing bacteria is Staphylococcus aureus. Strains of Streptococci bacteria could also cause an infection.
Deep-Skin and Soft-Tissue Infection
With this type of infection, the patient may be seriously ill and suffering from pain in the soft tissues of the extremities. This type of infection usually will not involve wound discharge. However, if present, the discharge will often be foul.
Extreme pain and tenderness may suggest clostridia infection (ie, gas gangrene).
Acute osteomyelitis, once known as “bone fever,” is an inflamed bone condition as a result of an infection. Patients usually feel bone pain at the site of infection. Though bones are not structurally susceptible to bacterial infection, trauma, surgery, and foreign bodies can lead to infection. Often, a patient suffering from this condition will have healed from a wound, and it takes a few days for the onset of acute osteomyelitis to be observed.
Chronic osteomyelitis can be contracted from blood borne pathogens carried from an infection elsewhere in the body, or as a result of infection from fracture or open surgery. Chronic osteomyelitis is generally observed in adults, especially those with affected by Diabetes or peripheral vascular disease. Poor blood flow makes healing difficult and the condition is labeled as chronic because of its likelihood to remain or recur even after multiple treatments. While treatment may initially start with antibiotics, surgical removal of infected bone tissue may be required to prevent its spread. If the infection is allowed to worsen, amputation may be necessary.
This type of infection is also characterized by deep, penetrating ulcers and deep sinus tracts. Such ulcers are commonly found between toes or on the plantar surface of the foot.
Diagnosis and Treatment
It’s critical for diabetes patients or those suffering from peripheral vascular disease to seek immediate medial attention when dealing with a wound, or symptoms like those described above. A podiatrist will be able to assist you in the proper diagnosis of foot and ankle problems, as well as the most effective treatments based on your personal medical history.
At Houston Foot and Ankle Care, we are committed to the long-term health of our patients. We’ve developed a great reputation through our success in helping Diabetic patients maintain their mobility and foot and ankle function. Through routine foot checkups and care, they can more effectively avoid the complications of tissue damage and infection. If you need a foot care specialist who can work with you to prevent foot problems, call us at (713) 541-3199 to schedule an appointment with Dr. Gabriel Maislos, DPM, FACFAS. We accept most major forms of medical insurance.
Call (713) 541-3199 if you experience:
- pain, redness or swelling
- localized bone pain
- foot ulcers or infection