Department of Emergency Medicine, Cooper University Hospital, Camden, NJ, USA.
Postgrad Med. 2010 Jul;122(4):213-7. doi: 10.3810/pgm.2010.07.2189.
We report the case of a 62-year-old African American woman with poorly controlled diabetes who presented with the complaint of not being able to remove her stockings from her left foot. The patient had long-standing peripheral neuropathy from diabetes. Her physical examination in the emergency department was challenging because of extensive infection in her left lower extremity. Careful removal of the stockings resulted in the debridement of the lower third of her left leg and entire foot. Her laboratory findings were notable for a white blood cell count of 11.7 x 10(3) cells/mm(3) with 18% bands, an erythrocyte sedimentation rate of 100 mm/hour, and glycated hemoglobin of 11.5%. This case is unique in that the patient presented with both wet and dry gangrene of her lower extremities. We discuss the spectrum of infectious processes in diabetic foot infections and discuss the management of patients with necrotizing fasciitis.
我们报告了一例 62 岁的非裔美国女性，患有控制不佳的糖尿病，她主诉无法将左脚上的袜子脱下。该患者患有长期糖尿病外周神经病变。由于左下肢广泛感染，她在急诊科的体格检查极具挑战性。仔细脱下袜子后，她的左小腿下段和整个脚部都被清创。她的实验室检查结果显示白细胞计数为 11.7 x 10(3)细胞/mm(3)，其中 18%为带状细胞，红细胞沉降率为 100 mm/hour，糖化血红蛋白为 11.5%。该病例的独特之处在于患者下肢同时出现湿性和干性坏疽。我们讨论了糖尿病足感染中感染过程的范围，并讨论了坏死性筋膜炎患者的治疗。
