UNIGE document Scientific Article - Review
previous document  unige:72719  next document
add to browser collection
Title

Challenges in diagnosing infection in the diabetic foot

Authors
Glaudemans, A W J M
Lipsky, B A
Published in Diabetic Medicine. 2015, vol. 32, no. 6, p. 748-59
Abstract Diagnosing the presence of infection in the foot of a patient with diabetes can sometimes be a difficult task. Because open wounds are always colonized with microorganisms, most agree that infection should be diagnosed by the presence of systemic or local signs of inflammation. Determining whether or not infection is present in bone can be especially difficult. Diagnosis begins with a history and physical examination in which both classic and 'secondary' findings suggesting invasion of microorganisms or a host response are sought. Serological tests may be helpful, especially measurement of the erythrocyte sedimentation rate in osteomyelitis, but all (including bone biomarkers and procalcitonin) are relatively non-specific. Cultures of properly obtained soft tissue and bone specimens can diagnose and define the causative pathogens in diabetic foot infections. Newer molecular microbial techniques, which may not only identify more organisms but also virulence factors and antibiotic resistance, look very promising. Imaging tests generally begin with plain X-rays; when these are inconclusive or when more detail of bone or soft tissue abnormalities is required, more advanced studies are needed. Among these, magnetic resonance imaging is generally superior to standard radionuclide studies, but newer hybrid imaging techniques (single-photon emission computed tomography/computed tomography, positron emission tomography/computed tomography and positron emission tomography/magnetic resonance imaging) look to be useful techniques, and new radiopharmaceuticals are on the horizon. In some cases, ultrasonography, photographic and thermographic methods may also be diagnostically useful. Improved methods developed and tested over the past decade have clearly increased our accuracy in diagnosing diabetic foot infections.
Identifiers
PMID: 25765225
Full text
Article (Published version) (781 Kb) - document accessible for UNIGE members only Limited access to UNIGE
Structures
Research group Chirurgie orthopédique et traumatologique (98)
Citation
(ISO format)
GLAUDEMANS, A W J M, UCKAY, Ilker, LIPSKY, B A. Challenges in diagnosing infection in the diabetic foot. In: Diabetic Medicine, 2015, vol. 32, n° 6, p. 748-59. https://archive-ouverte.unige.ch/unige:72719

158 hits

0 download

Update

Deposited on : 2015-05-21

Export document
Format :
Citation style :