| Autor: |
Papaetis GS; Internal Medicine and Diabetes Clinic, K.M.P. THERAPIS Paphos Medical Center, Paphos, Cyprus.; CDA College, Paphos, Cyprus., Doukanaris PT; Outpatient Parenteral Antibiotic Therapy (OPAT) Services, Evangelismos Hospital, Paphos, Cyprus., Stylianou ES; Department of Radiology, Alpha Evresis Diagnostic Center, Bioiatriki Healthcare Group, Nicosia, Cyprus., Neofytou MS; Department of Interventional Cardiology, American Medical Center, Nicosia, Cyprus. |
| Jazyk: |
angličtina |
| Zdroj: |
The American journal of case reports [Am J Case Rep] 2023 Nov 01; Vol. 24, pp. e941337. Date of Electronic Publication: 2023 Nov 01. |
| DOI: |
10.12659/AJCR.941337 |
| Abstrakt: |
BACKGROUND Foot ulcers are high-morbidity and debilitating complications of diabetes mellitus, and carry significantly increased rates of associated major amputations. They contribute to significantly worse quality of life. Osteomyelitis is a frequent complication of diabetic foot ulcers, since bacteria can contiguously spread from soft tissues to the bone, involving the cortex first and then the bone marrow. Unfortunately, clinically unsuspected osteomyelitis is frequent in persisting diabetic foot ulcers. It is associated with limb amputations and increased mortality. CASE REPORT We describe a 76-year-old man with long-standing insulin-treated type 2 diabetes, who experienced extensively drug-resistant Enterococcus faecalis diabetic foot myositis and osteomyelitis associated with sepsis. He was successfully treated with surgical debridement combined with the administration of teicoplanin plus rifampicin in the outpatient setting, completing, in total, a twelve-week course of antibiotic therapy. CONCLUSIONS Clinically unsuspected osteomyelitis in patients with persisting diabetic foot ulcers has been associated with infections from highly resistant bacteria. Early and accurate diagnosis of diabetic foot osteomyelitis, as well as proper therapeutic approach (antimicrobial and surgical), is of great importance to reduce the risk of minor and major amputations, septic shock leading to multiple organ failure, and overall mortality. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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