[ Diabetes Type 2 ]

Outcomes of Osteomyelitis in Patients Hospitalized With Diabetic Foot Infections


The forefoot has been reported as the most frequent location of osteomyelitis in the feet of patients with diabetes. Special sections include articles on antimicrobial resistance, bioterrorism, emerging infections, food safety, hospital epidemiology, and HIV/AIDS. One of the major topics of our sessions was diabetic foot infection as well as a specific session dealing with diabetic foot osteomyelitis (DFO). A HMPAO-Leu uptake without concordant bone MDP activity was considered as a soft-tissue infection. If confirmed, these data may have an impact on the choice of antimicrobial regimen used in these patients, because coagulase-negative staphylococci are usually considered to be contaminants in such conditions. Transtibial amputation was performed in 1 (0.33%) patient with forefoot osteomyelitis, in 5 (18.5%) patients with midfoot osteomyelitis, and in 12 (52.2%) patients with osteomyelitis of the heel (χ2 = 128.4, P < .001). CRP, ESR, PCT and IL-6 levels significantly declined in the group with osteomyelitis after starting therapy, while MCP-1 increased (P = 0·002). Osteomyelitis must be considered as a potential complication of any deep ulcer. Wound healing was achieved by secondary intention for a median of 8 weeks. In patients who develop osteomyelitis in the setting of vascular insufficiency, infection occurs most often in the small bones of the feet. Performing conservative surgeries without amputations of any part of the foot is not always feasible in cases in which the infection has destroyed the soft tissue envelope.

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