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Diabetic Foot Infections


Diabetic Foot Infections

Thayne, WY

Diabetic foot infections are a common medical condition that can easily become worse without treatment. Without the proper medical attention, diabetic foot infections can easily lead to surgery or amputation. As a local Thayne podiatrist, we can help with diabetic foot infection care.

Diabetic foot infection care is available at Ambulatory Foot & Ankle Clinic in Thayne and the surrounding area. Do not put off getting the treatment you need. Call us today at 1-307-243-4080 to schedule an appointment or learn more about our services.


Understanding Diabetic Foot Infections

Diabetic foot infections are soft tissue or bone infections below the malleoli. They are the most common complication of diabetes leading to hospitalization, and they are also the most common cause of nontraumatic lower-extremity amputation. Diabetic foot infections can be mild, moderate, or severe.

Most diabetic foot infections are polymicrobial, with the most common pathogens being aerobic gram-positive cocci (primarily Staphylococcus species). Additionally, most diabetic foot infections occur in a site of ulceration or skin trauma. People with diabetes have a 15% to 25% lifetime risk of developing an ulcer and an annual incidence rate of 3% to 10%, making diabetic foot infections a common clinical phenomenon.

Symptoms of Diabetic Foot Infections

There are four main types of diabetic foot infections: cellulitis, deep-skin and soft-tissue infections, acute osteomyelitis, and chronic osteomyelitis. Cellulitis is characterized by tender, flat skin lesions, and it often occurs with lymphangitis (which suggests group A streptococcal infection). Patients may also have bullae (fluid-filled blisters) but no ulcer or wound exudate.

Deep-skin and soft-tissue infections cause the patient to fall acutely ill, and the affected soft tissues may harden. There is usually no wound discharge, although there may be extreme pain and tenderness that indicate compartment syndrome or clostridial infection. There may also be bullae and discharge (which may or may not smell foul).

With acute osteomyelitis, patients will typically experience pain at the site of the involved bone unless peripheral neuropathy is also present. There is usually no fever or swollen lymph nodes. Patients with chronic osteomyelitis may experience low fever, foul-smelling discharge, and deep ulcers between the toes or on the bottom of the foot. There may or may not be pain, depending on the patient’s degree of neuropathy, and the shins or heels will typically not be affected.

Complications of Diabetic Foot Infections

Uncontrolled diabetes can lead to diabetic neuropathy or damage to the nerves. As a result, affected individuals may lose sensation in the feet. This makes it extraordinarily easy for cuts or sores to form and worsen unnoticed. Diabetes also affects blood flow, prolonging the amount of time it takes for a sore or cut to heal.

All of this leads to an increased risk of infection, which leads to an increased risk of other complications. For example, when poor blood flow prolongs healing time, individuals are at risk for developing ulcers or gangrene. Ultimately, this may necessitate amputation. Infections can also eat into bones or tissue, creating pockets of pus known as abscesses.

Treating Diabetic Foot Infections

Treatment for diabetic foot infections varies depending on the severity of the patient’s condition and can range from antibiotic therapy to surgical treatments. Mild to moderate diabetic foot infections with normal Ankle-Brachial Index (ABI) or Toe-Brachial Index (TBI) may require oral antibiotics and outpatient management. On the other hand, mild to moderate diabetic foot infections with abnormal Ankle-Brachial Index (ABI) or Toe-Brachial Index (TBI) may require vascular surgery.

In either case, the patient should undergo an X-ray to check for osteomyelitis. If they test positive, podiatry may be necessary to perform a bone biopsy and debridement. Amputation may or may not follow. If the patient tests negative for osteomyelitis, podiatry may assist with wound care.

Severe diabetic foot infections will require resuscitation and broad-spectrum antibiotics. If the patient has wet gangrene or two or more Systemic inflammatory response syndrome (SIRS) criteria with a possible need for emergency amputation, vascular surgery may be necessary. If the patient does not have wet gangrene or two or more SIRS criteria with a potential need for emergency amputation, but there is a possibility of necrotizing fasciitis, acute care surgical services may be necessary.

Call Us Today

If you have a diabetic foot infection, you should never hesitate to get the treatment you need. Our podiatrist and team at Ambulatory Foot & Ankle Clinic can help. Call us today at 1-307-243-4080 to schedule an appointment or learn more about our services.

Frequently Asked Questions

What are the risk factors for developing a diabetic foot ulcer?

Anyone with diabetes can develop a diabetic foot ulcer. However, they tend to be more common in patients who have diabetes for over ten years, are male, have poor glucose control, and have cardiovascular, retinal, or renal complications. Amputation is also more common in those with peripheral sensory neuropathy, peripheral motor neuropathy, peripheral vascular disease, a history of foot ulcers or amputation, and severe nail pathology.

How do microorganisms enter the foot?

Bacteria most frequently enter the foot through an open wound, such as an ulcer. They can also enter the foot through any cracks in the webbed space between the toes or created due to direct punctures. Neuropathy and vascular insufficiency are responsible for most diabetic foot ulcers.

Do all patients with diabetic foot ulcers need antibiotic therapy?

No. Only patients whose ulcers show signs of inflammation, have oozing discharge, or are suspected of having underlying osteomyelitis need antibiotic therapy. However, foot ulcers that persist for longer than four weeks will require careful workup for neuropathy and vascular insufficiency.

Which antibiotics are most commonly used for outpatient patients with diabetic foot infections?

Gram-positive cocci like Staphylococci and Streptococci are the most common causative agents of diabetic foot infections. As such, oral narrow-spectrum agents have shown to be effective. These include Clindamycin, Cephalexin, and Amoxicillin.

When will I need to go to a hospital for my diabetic foot infection?

Anyone with a limb- or life-threatening infection will need to be hospitalized. This includes patients with ulcers with surrounding cellulitis, tissue necrosis, systemic toxicity, osteomyelitis, bacteremia, or ulcers extending into deep tissues. Such patients will receive intravenous antimicrobial therapy and surgical intervention.

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