What
are the signs of a foot infection?
The
signs of infection are redness, increased temperature, pain
(often absent in people with diabetes), swelling and loss of
function (often not experienced by people with diabetes due
to lack of sensation). With severe infection, pus or a blue/black
color around the sight of infection may be seen. Often, diabetic
foot infections are treated in a hospital setting.
How
are foot infections treated?
The
first principle of foot infection management is to avoid weight
bearing. This may mean that your doctor will want you to stay
in bed. While this can become frustrating after a while, it
has been shown to improve outcome and prevent worsening of the
infection.
Initial
tests are usually ordered to assess the infection after your
doctor examines you. This may include a number of different
x-ray tests, ranging from a simple x-ray to computed
tomography (CT) scan,
magnetic
resonance imaging (MRI) or other imaging studied.
These
tests are painless and allow your doctor to know how extensive
the infection is. Sometimes the infection extends into the bone,
which requires prolonged antibiotic therapy (usually around
six weeks). Routine blood tests are also ordered.
Antibiotics
are then given and are an extremely important part of therapy.
These are often given by the intravenous (I.V.) route, which
means you will have to have an IV in your arm while you are
in the hospital. Powerful antibiotics are required to treat
these often-complicated infections.
Once
antibiotics are given for several days, your doctor will need
to assess whether therapy is working. If the infection progresses
or does not improve, surgical intervention is usually required.
This can take many forms.
Because
of the many innovations in medical care over the last few decades,
multiple efforts are usually undertaken to avoid limb amputation.
Usually, the first surgical procedure is debridement. Debridement
means that all non-living tissue is removed and the underlying
tissue cleaned thoroughly.
This
may even be done right away if the infection is severe. After
debridement, the surgical wound is often left open to drain
while antibiotics are continued. Daily (or more frequent) dressing
changes are done as the patient continues to avoid weight bearing
If these measures are unsuccessful, amputation is often required.
Amputation can range from partial toe resection to removing
the bottom half of the leg. This is obviously the most feared
complication of a diabetic foot infection.
Once
the infection has resolved, whether through antibiotics or more
severe measures, your doctor may want to assess the blood flow
in your legs. There are different types of imaging studies available
to look at blood flow, most of which are painless.
These
measures are often important, as you may need a surgical bypass
in your legs, much like those with heart attacks that need bypass
surgery. If the arteries in your legs are clogged, a bypass
may prevent severe foot infections in the future by allowing
more blood to reach your legs.
Foot
infections in the people with diabetes are common and in many
cases, curable with antibiotic therapy. However, they can lead
to one of the most feared complications of diabetes amputation.
A person with diabetes should seek immediate medical attention
for any foot infection that occurs.
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© 2000 PersonalMD.com. All rights reserved.
Many
of us choose to ignore our feet unless they are hurting us.
For the diabetic, this would be a dangerous proposition. Diabetes
is by far the number one cause of lower limb 
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