الفهرس Only 14 pages are availabe for public view
 |  | from | 201 |  |  |
| | | from | 201 | | |
Abstract
Foot infections in patients with diabetes cause substantial morbidity and frequent visits to health care professionals and may lead to amputation of a lower extremity
Diabetic foot infections require attention to local (foot) and systemic (metabolic) issues and coordinated management, preferably by a multidisciplinary foot-care team. The team managing these infections should include, or have ready access to, an infectious diseases specialist or medical microbiologist
The major predisposing factor to these infections is foot ulceration, which is usually related to peripheral neuropathy .Peripheral vascular disease and various immunological disturbances play a secondary role
Aerobic gram-positive cocci(especially Staphyloccus aureus) are the predominant pathogens in diabetic foot infections. Patients who have chronic wounds or who have recently received antibiotic therapy may also be infected with gram-negative rods, and those with foot ischemia or gangrene may have obligate anaerobic oathogens
Wound infections must be diagnosed clinically on the basis of local(and occasionally systemic) signs and symptoms of inflammation. Laboratory investigations are of limited use for diagnosing infection, except in cases of osteomyelitis
Appropriately obtained specimens should be sent for culture prior to starting empirical antibiotic therapy in all cases of infection, except perhaps those that are mild and previously untreated. Tissue specimens obtained by biopsy, ulcer curettage, or aspiration are preferable to wound swab specimens