Vazeille Stephan, Hawker Lydia, Chandrasekar Ramasubramanyan, Srinivas-Shankar Upendram
Diabetes and Endocrinology, Wirral University Teaching Hospital, Birkenhead, GBR.
Vascular Surgery, Wirral University Teaching Hospital, Birkenhead, GBR.
Cureus. 2020 Jun 29;12(6):e8898. doi: 10.7759/cureus.8898.
We describe the case of a middle-aged woman with type 1 diabetes mellitus who presented to the emergency department with diabetic ketoacidosis. An intravenous cannula was inserted into the veins of the dorsum of the right foot due to difficulty in obtaining intravenous access in the upper limb for managing diabetic ketoacidosis. Our patient developed edema and bullae on the dorsum of the right foot and received intravenous antibiotics for bullous cellulitis. Our patient developed ulceration on the dorsum of the right foot and over the next few months was admitted to hospital on several occasions with infected foot ulceration, which required several courses of intravenous antibiotics, larval therapy and surgical debridement of the necrotic eschar and slough. With regular review in the multidisciplinary diabetic foot clinic, the foot ulceration finally healed in eight months. This case highlights the importance of avoiding trauma in any form to the feet of people with diabetes even if aseptic techniques are taken.
我们描述了一名患有1型糖尿病的中年女性病例，她因糖尿病酮症酸中毒被送往急诊科。由于上肢难以建立静脉通路来治疗糖尿病酮症酸中毒，遂在右脚背静脉插入了静脉套管。我们的患者右脚背出现水肿和大疱，并因大疱性蜂窝织炎接受了静脉抗生素治疗。患者右脚背出现溃疡，在接下来的几个月里多次因足部溃疡感染入院，这需要几个疗程的静脉抗生素治疗、幼虫疗法以及对坏死焦痂和腐肉进行手术清创。通过在多学科糖尿病足诊所的定期复查，足部溃疡最终在八个月后愈合。该病例强调了即使采取了无菌技术，也要避免对糖尿病患者的足部造成任何形式创伤的重要性。
