Diabetes mellitus and infection: Skin and soft tissue infection

Abstract

Skin and soft tissue (SST) infections are the most frequent infections in diabetics with a major risk of complications. We aim to describe clinical and therapeutic particularities and the evolution of SST infections in diabetics. A retrospective study including diabetic patients admitted for SST infections in the infectious disease department of Sfax Tunisia between 2015 and 2023. We collected 30 patients. The median age was 62.3 years. Type 2 diabetes was found in 80% of cases. The diagnosis of SST infections was based on clinical manifestations. Fever was found in 76.6% of cases. The local inflammatory signs had a circumferential extension in 43.3% of cases. Infected injury (35.1%), intertrigo interdigital (21.2%) and plantar fissure (14.5%) were the most common causes of this infection. Necrotizing fasciitis, abscess and gangrene were found respectively in 29.8%, 12.8% and 6.6%. Seven patients (23.3%) had general complications like hemodynamic instability (35.3%), respiratory distress (35.3%) and loss of consciousness (51.3%). Seventeen patients had unbalanced diabetes (56.6%) and five patients had ketosis decompensation (16.6%). The treatment was based on the association of antibiotics in 59.9% of cases. The most used association was amoxicillin–clavulanic acid and clindamycin (34.24%). Ten patients (33.3%) had surgical intervention. Recurrence was found in 16.3% and mortality in 6.6% of cases. SST infections can progress rapidly with significant morbidity if not treated promptly. The main way to prevent SST infections is good control of diabetes and foot hygiene [1].