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Be careful!Diabetic foot infection hidden under neuropathy

Diabetic foot infection (DFI) is one of the common, complex and expensive complications of diabetic patients. If it is not diagnosed and properly treated in time in time, the foot infection is likely to progress to the deep tissue, severe infection or amputation, or even endangering that it is endangered Life, so it is necessary to attract the attention of all physicians.

Neuropathy cover up the symptoms of infection

Most patients with diabetic foot have neuropathy. After diabetes combined with neuropathy, it may cause dull or disappear, so some symptoms of infection are covered up by neuropathy. The infection of diabetic feet can be manifested as no pain, fever and hyperglycemia. Usually those typical symptoms of infection -red, fever, pain, etc. may be covered by neuropathy. Therefore The redness, swelling, abrasion, blisters, fissure, ringworm, metalitis, etc. When you find these problems, you should go to the hospital for treatment in time and deal with it as soon as possible.

Some patients’ foot ulcers are under the 胼胝, because they weaken the pain, so it is not easy to find that the ulcer restricting pus can cause the occurrence of honeycomb woven inflammation and the rapid deterioration of the disease. Therefore Gathering blisters, or changes in colors under or toes, and even pain or discomfort occurred. When swelling, fever, erythema, etc., they need to be vigilant. This is likely to be a sign of foot infection. Some elderly diabetic patients often have rarely fever in the body due to damage to immune function, so clinical characteristics are important.

Infection grades according to the size of the wound

If DFI is diagnosed, it is necessary to severity points for infection, which is very important for subsequent treatment. It can be simply divided into level 4, level 1 (no infection), level 2 (mild infection), level 3 (moderate infection), level 4 (severe infection). Generally, skin and subcutaneous infections within 2cm of the wound are mild; infection of the wound 2cm or deeper, and subcutaneous tissue infection belongs to moderate; on a moderate basis, it is severe when combined with systemic symptoms and signs.

The range of moderate infections is wide, such as abscess, osteomyelitis, purulent arthritis, and fasciitis, which are all in this scope. At this time, correct treatment is very important and determines the prognosis of DFI.

Antibiotic use suggestion

1. If there are clinical infections, antibiotics must be used, but for patients without clinical infections, antibiotics are not recommended.

2. For patients with mild infection, antibiotics are generally needed for 1-2 weeks.

3. For patients with moderate infection, choose oral antibiotics and venous antibiotics according to the situation. If it is limited to skin and subcutaneous infections, it can be administered in orally. If the lesion accumulates deep tissue, it is recommended to administer intravenous veins.

4. For patients with severe infections, the most importantly tissue of the medicine for bacterial culture and medicinal sensitivity test is most important to use the medicine. Before the results of bacterial culture have not come out, you can first experience the administration to avoid worsening the condition. The wound surface is shallow, mostly infected with Gram -positive bacteria, and penicillin or one -generation cephalosporin can be selected. For patients with moderate or severe infection, those with deeper wounds are mostly hybrid bacteria infections mainly in Gram -negative bacteria. It is recommended to choose three generations of cephalosporin. If it is accompanied by a bad smell, consider combined with anaerobic bacteria, and give combined with antimony antibiotic drugs.

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5. After 2-3 days of antibiotics, the efficacy assessment is performed, and the treatment plan is adjusted in combination with the results of the drug sensitivity test.

6. If bone marrowitis is merged, you need to clear the necrotic joint capsules and tendons around the infection bone in time. For multi -department consultations with no relevant experience, comprehensive treatment is required.

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