Diagnosis and treatment of diabetic foot infections

Prompt clinical diagnosis and timely treatment are the hallmarks of the proper care of diabetic patients with foot infections. The importance of careful clinical foot examination cannot be overemphasized. When infection is suspected, effort should be made to search for deeper infections, especially osteomyelitis. Numerous imaging techniques are available, but their cost-effectiveness has not been fully determined. Radiography of the foot is less sensitive but can provide useful information at a lower cost. Radio-isotope studies have not yielded consistent results, but the newer techniques deserve attention. Microbiological diagnosis should be attempted using only deep tissue culture, including bone biopsy. The primary aim of treatment of the infected foot is to restore ambulation. Timely surgical intervention and appropriate antimicrobial therapy can reduce the incidence of above-ankle amputation and reduce the length of hospital stay.