Clinical case of diabetic foot infected by Escherichia coli in Meggitt-Wagner stages III–IV
Keywords:
INFECCIÓN DE HERIDAS; INFECCIONES POR ESCHERICHIA COLI; PIE DIABÉTICO; ÚLCERA DEL PIE., WOUND INFECTION; ESCHERICHIA COLI INFECTIONS; DIABETIC FOOT; FOOT ULCER., INFECÇÃO DE FERIDAS; INFECÇÕES POR ESCHERICHIA COLI; PÉ DIABÉTICO; ÚLCERA DO PÉ.Abstract
Introduction: diabetic foot is one of the most severe chronic complications of diabetes mellitus, associated with infections, vascular impairment, and a high risk of amputation when timely and comprehensive management is not implemented.
Objective: to describe the clinical course and therapeutic approach of a patient with advanced diabetic foot complicated by opportunistic bacterial infection.
Case presentation: a 62-year-old male patient with a history of type 2 diabetes mellitus and arterial hypertension presented with a progressive ulceration on the right foot of twelve days’ duration. Clinical examination revealed an extensive lesion measuring between five and ten centimeters, with deep tissue involvement, presence of larvae, and signs of severe infection, consistent with stages III–IV of the Meggitt-Wagner classification. Laboratory studies showed marked hyperglycemia, leukocytosis with neutrophilia, and progressive anemia. Culture of the secretion identified Escherichia coli as the causative agent, with a favorable antimicrobial sensitivity pattern. Doppler ultrasound ruled out thrombosis but revealed venous insufficiency and arteriosclerosis. Treatment was initiated with daily wound care, metabolic control, targeted antibiotic therapy, and comprehensive management of the patient’s general and emotional condition, resulting in favorable clinical evolution.
Conclusions: comprehensive management of advanced diabetic foot, based on timely microbiological diagnosis and targeted antibiotic therapy, can prevent amputations even in severe stages. This case highlights the importance of multidisciplinary care and metabolic and emotional control in patients with chronic diseases.
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