Diabetic foot infection

Abstract

Diabetic foot infection DFI is simply defined as suspected or documented infection of the tissues that comprise the foot of a diabetic patient. Diabetic foot infection is often caused by introduction of an infection into the otherwise sterile soft tissues of the foot through a minor skin break down. Diabetic foot infection may be mild usually restricted to the uppermost layers of the skin, moderate extending down to the soft tissues of the foot or severe infection associated with systemic toxicity or metabolic instability. The paper reviews the types of DFI, pathophysiology, microbiology of DFI, relevant anatomy of the foot, clinical evaluation, measures of severity of DFI, the role of radiological investigations, and the role of early surgical intervention in the prevention of progressive foot infection and limb salvage. It is concluded that the diagnosis of DFI should be suspected at an early stage based on the presence of local signs of inflammation with or without systemic signs of toxicity or metabolic instability. Optimal treatment of DFI requires a multimodality approach directed at controlling hyperglycemia, administration of systemic antibiotics, and local wound management to prevent the spread and dissemination of infection.