Charcot Arthropathy and Osteomyelitis: A Case of Diabetic Foot Syndrome

Abstract

Diabetes mellitus is a disease that affects millions around the globe. It also comes with a major complication, diabetic foot ulcers. Lower extremities having little to no vascularity in diabetic people leads to wounds that are unable to heal on their own. These wounds later become infected and cause osteomyelitis, a condition in which the infection in soft tissues of the lower extremities spread to the bones of the foot.Charcot arthropathy is one of the more serious foot issues that can arise from diabetic neuropathy. The soft tissues, joints, and bones of the foot or ankle are all impacted by Charcot. The joints in the foot or ankle might dislocate when the bones deteriorate and become brittle. Diabetes patients who have their soft tissues and bones infected might even have to get their extremities amputated if not managed right on time. We describe the case of a 66-year-old man with type 1 diabetes mellitus who presented to the emergency department with increasing pain in the right foot. There was a hyperemic discharge coming out of his wound which increased gradually over time. The patient’s been using Lantus and Novorapid and his blood glucose measurement at the time of admission was 466. Our patient said that he was hospitalized in the intensive care unit due to diabetic ketoacidosis 20 days before he applied to our emergency department, and his wounds, discharge, pain, and redness increased after this incident. We requested his anteroposterior and lateral radiographs of the right foot and a lower extremity CT. The scans were examined carefully and at last, amputation was recommended for the patient. The patient did decline our offer and wanted to go home with a dressing. Ampicillin/sulbactam and ciprofloxacin were started. We also recommended him see infectious diseases and plastic surgery consultants in the following daysI hope you may be interested in the results of our study in this direction.