Hale Andrew J, Vicks Emily, LaSalvia Mary T, Giurini John M, Karchmer Adolf W
J Am Podiatr Med Assoc. 2018 Nov;108(6):528-531. doi: 10.7547/17-139.
Diabetic foot infections are a common cause of morbidity and mortality in the United States, and successful treatment often requires an aggressive and prolonged approach. Recent work has elucidated the importance of appropriate therapy for a given severity of diabetic foot infection, and highlighted the ongoing risk such patients have for subsequent invasive life-threatening infection should diabetic foot ulcers fail to heal. The authors describe the case of a man with diabetes who had prolonged, delayed healing of a diabetic foot ulcer. The ulcer subsequently became infected by methicillin-resistant Staphylococcus aureus (MRSA). The infection was treated conservatively with oral therapy and minimal debridement. Several months later, he experienced MRSA bloodstream infection and complicating endocarditis. The case highlights the ongoing risk faced by patients when diabetic foot ulcers do not heal promptly, and emphasizes the need for aggressive therapy to promote rapid healing and eradication of MRSA.
糖尿病足感染是美国发病和死亡的常见原因，成功的治疗通常需要积极且长期的方法。近期研究阐明了针对特定严重程度的糖尿病足感染进行适当治疗的重要性，并强调了如果糖尿病足溃疡未能愈合，此类患者随后发生危及生命的侵袭性感染的持续风险。作者描述了一名患有糖尿病的男性病例，其糖尿病足溃疡愈合时间延长且延迟。该溃疡随后被耐甲氧西林金黄色葡萄球菌（MRSA）感染。感染采用口服治疗和最小限度清创进行保守治疗。几个月后，他发生了MRSA血流感染并并发心内膜炎。该病例凸显了糖尿病足溃疡未及时愈合时患者面临的持续风险，并强调了积极治疗以促进快速愈合和根除MRSA的必要性。
