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==Overview==
==Overview==
Worsened [[Diabetes management|glycemic control]] could be seen in laboratory evaluation of [[diabetic foot]] [[patients]]. Even in the presence of [[infection]], there is no guarantee that measures such as [[White blood cells]] ([[White blood cells|WBC]]), [[Erythrocyte sedimentation rate]] ([[Erythrocyte sedimentation rate|ESR]]), and [[C-reactive protein]] ([[C-reactive protein|CRP]]) be elevated. For detection of main responsible [[microorganisms]] [[biopsy]], [[curettage]], or aspiration, a tissue sample is recommended. It is recommended to obtain a sample from discharge of [[ulcer]]'s base. Moreover, due to contamination of all [[ulcers]], culture from non-[[infection|infectious]] [[ulcers]] is not recommended. For confirming [[osteomyelitis]] [[diagnosis]] and for appropriate [[antibiotic]] [[treatment]], it is critical to obtain a [[bone]] [[biopsy]]. Properly obtained specimens for [[Tissue culture|culture]] prior to initiating [[empiric therapy]] provide useful information for guiding [[antibiotic]] selection, particularly in those with [[Chronic (medical)|chronic]] or previously [[treatnent|treated]] [[infections]] which are commonly caused by [[gram-negative bacilli]] or [[obligate anaerobic|obligate anaerobic organisms]].
Worsened [[Diabetes management|glycemic control]] could be seen in the laboratory evaluation of [[diabetic foot]] [[patients]]. Even in the presence of [[infection]], there is no guarantee that measures such as [[White blood cells]] ([[White blood cells|WBC]]), [[Erythrocyte sedimentation rate]] ([[Erythrocyte sedimentation rate|ESR]]), and [[C-reactive protein]] ([[C-reactive protein|CRP]]) be elevated. For detection of the main responsible [[microorganisms]] [[biopsy]], [[curettage]], or aspiration, a tissue sample is recommended. It is recommended to obtain a sample from discharge of the [[ulcer]]'s base. Moreover, due to contamination of all [[ulcers]], culture from non-[[infection|infectious]] [[ulcers]] is not recommended. For confirming [[osteomyelitis]] [[diagnosis]] and for appropriate [[antibiotic]] [[treatment]], it is critical to obtain a [[bone]] [[biopsy]]. Properly obtained specimens for [[Tissue culture|culture]] prior to initiating [[empiric therapy]] provide useful information for guiding [[antibiotic]] selection, particularly in those with [[Chronic (medical)|chronic]] or previously [[treatnent|treated]] [[infections]] which are commonly caused by [[gram-negative bacilli]] or [[obligate anaerobic|obligate anaerobic organisms]].


==Laboratory Findings==
==Laboratory Findings==

Revision as of 18:06, 14 September 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2]

Overview

Worsened glycemic control could be seen in the laboratory evaluation of diabetic foot patients. Even in the presence of infection, there is no guarantee that measures such as White blood cells (WBC), Erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) be elevated. For detection of the main responsible microorganisms biopsy, curettage, or aspiration, a tissue sample is recommended. It is recommended to obtain a sample from discharge of the ulcer's base. Moreover, due to contamination of all ulcers, culture from non-infectious ulcers is not recommended. For confirming osteomyelitis diagnosis and for appropriate antibiotic treatment, it is critical to obtain a bone biopsy. Properly obtained specimens for culture prior to initiating empiric therapy provide useful information for guiding antibiotic selection, particularly in those with chronic or previously treated infections which are commonly caused by gram-negative bacilli or obligate anaerobic organisms.

Laboratory Findings

Obtaining Specimens

References

  1. Lepäntalo, M.; Apelqvist, J.; Setacci, C.; Ricco, J.-B.; de Donato, G.; Becker, F.; Robert-Ebadi, H.; Cao, P.; Eckstein, H.H.; De Rango, P.; Diehm, N.; Schmidli, J.; Teraa, M.; Moll, F.L.; Dick, F.; Davies, A.H. (2011). "Chapter V: Diabetic Foot". European Journal of Vascular and Endovascular Surgery. 42: S60–S74. doi:10.1016/S1078-5884(11)60012-9. ISSN 1078-5884.
  2. Lipsky, Benjamin A. (2004). "A report from the international consensus on diagnosing and treating the infected diabetic foot". Diabetes/Metabolism Research and Reviews. 20 (S1): S68–S77. doi:10.1002/dmrr.453. ISSN 1520-7552.
  3. American Diabetes Association (1999). "Consensus Development Conference on Diabetic Foot Wound Care: 7-8 April 1999, Boston, Massachusetts. American Diabetes Association". Diabetes Care. 22 (8): 1354–60. doi:10.2337/diacare.22.8.1354. PMID 10480782.
  4. Lipsky BA (1997). "Osteomyelitis of the foot in diabetic patients". Clin Infect Dis. 25 (6): 1318–26. doi:10.1086/516148. PMID 9431370.
  5. Wukich DK, Armstrong DG, Attinger CE, Boulton AJ, Burns PR, Frykberg RG; et al. (2013). "Inpatient management of diabetic foot disorders: a clinical guide". Diabetes Care. 36 (9): 2862–71. doi:10.2337/dc12-2712. PMC 3747877. PMID 23970716.
  6. Lipsky BA, Berendt AR, Cornia PB, Pile JC, Peters EJ, Armstrong DG; et al. (2012). "2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections". Clin Infect Dis. 54 (12): e132–73. doi:10.1093/cid/cis346. PMID 22619242.