scholarly journals Diabetic Foot Osteomyelitis Caused by Francisella Tularensis

Author(s):  
Wissam K Kabbara ◽  
◽  
Maha-Sarah Fansa ◽  

Purpose: A rare patient case of a diabetic foot osteomyelitis caused by Francisella tularensis is presented. Summary: A 69-year-old Caucasian female was admitted for the treatment of diabetic foot osteomyelitis. Her past medical history included type II diabetes mellitus, hypertension, chronic kidney disease, coronary artery disease, hypothyroidism, hyperuricemia and thyroidectomy. Empiric antimicrobial therapy consisting of clindamycin 600mg i.v. every 8hrs and impanel/cilastatin 200 mg i.v. every 6hrs hours was initiated immediately after admission. During her hospitalization, a pus sample from the infection site was taken for culture which showed a gram negative microorganism: Francisella tularensis. The strain was resistant to all the antibiotics tested with the exception of ciprofloxacin, ofloxacin, gentamicin, ceftazidime, cefepime, piperacillin/tazobactam and colistin. After culture results, the treatment regimen was changed to piperacillin/tazobactam 4.5g i.v. every 12hrs and ciprofloxacin 400mg i.v. every 12hrs. The patient continued to receive both antibiotics during hospitalization for 9 days with noted clinical improvement. The patient was discharged on piperacillin/tazobactam 4.5g i.v. every 12hrs and oral ciprofloxacin 500mg every 12hrs to complete a total duration of 6 weeks. Conclusion: This is the first reported case of a diabetic foot osteomyelitis caused by Francisella tularensis.

Masker Medika ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 163-175
Author(s):  
Sukron Sukron

Latar Belakang : Meningkatnya angka penyakit diabetes melitus tipe 2 khususnya di Indonesia bersamaan dengan meningkatnya komplikasi salah satunya diabetic foot ulcer yang juga merupakan faktor terjadinya gangguan sensitivitas pada kaki. Pencegahan dapat dilakukan dengan mengukur sensitivitas kaki dengan menggunkan monofilmen test. Tujuan Penelitian : Untuk mengetahui gambaran tingkat sensitivitas kaki pada penderita diabetes melitus tipe 2 di Rumah Sakit Muhammadiyah Palembang. Metode Penelitian : Penelitian ini merupakan penelitian dengan metode Deskripti Analitik dengan pendekatan kuantitatif. Teknik sampling menggunakan convenience sampling pada pasien diabetes melitus tipe 2 di Rumah Sakit Muhammadiyah Palembang yang berjumlah 60 responden. Hasil : Hasil penelitian menunjukkan bahwa rata-rata pasien diabetes melitus tipe 2 berusia 59,45 tahun dan sebagaian besar berjenis kelamin laki-laki dengan tingkat pendidikan sebesar 33,3% SD dan 33,3% SMA. Rerata responden juga menderita diabetes melitus tipe 2 selama 3,58 tahun dengan sebagian besar responden tidak berkerja dan tidak berolahraga. Serta tingkat sensitivitas kaki pada pasien diabetes melitus tipe 2yang tidak ada rasa dengan frekuensi tertinggi yaitu pada dorsal kaki sebanyak 25 orang (41,67%), metatarsal head ke-1 sebanyak 23 orang (38,33%), Midfoot bagian Medial sebanyak 22 orang (36,67), jari tengah sebnayk 21 orang (35%), metatarsal head ke-3 sebanyak 20 orang (33,33%), Midfoot bagian lateral sebanyak 20 orang (33,33%), Tumit sebanyak 18 orang (30%), jari kelingking sebanyak 18 orang (30%), metatarsal haed ke-2 sebanyak 17 orang (28,33%), dan terendah yaitu padajempol kaki dengan frekuensi 12 responden (20%). Kesimpulan : sensitivitas kaki pada pasien diabetes melitus tipe II yaitu terendah pada dorsal kaki.   Background: The increasing number of type II diabetes mellitus, especially in Indonesia together with the increase in complications, one of which is diabetic foot ulcer, which is also a factor in sensitivity to the feet. Prevention can be done by measuring foot sensitivity by using a monofilment test. Objective: To find out the description of the level of sensitivity of the foot in patients with type II diabetes mellitus patients in Muhammadiyah Hospital Palembang. Method of Researvh: This research is a research with Analytic Descriptive method with quantitative approach. The sampling technique uses convenience sampling in patients with type II diabetes mellitus at Muhammadiyah Hospital Palembang, amounting to 60 respondents. Result of Research: The results showed that the average type II diabetes mellitus patients were 59.45 years old and most were male with education level of 33.3% elementary school and 33.3% high school. The average respondent also suffered from type II diabetes mellitus for 3.58 years with most respondents not working and not exercising. And the level of sensitivity of the foot in patients with type II diabetes mellitus that does not have the highest frequency is the dorsal foot of 25 people (41.67%), the first metatarsal head of 23 people (38.33%), Midfoot of the Medial section of 22 people (36.67), middle fingers 21 people (35%), 3rd metatarsal head as many as 20 people (33.33%), lateral midfoot as many as 20 people (33.33%), Heel as many as 18 people ( 30%), the pinky finger was 18 people (30%), the second metatarsal haed were 17 people (28.33%), and the lowest was the big toe with a frequency of 12 respondents (20%). Conclusion: Foot sensitivity in type II diabetes mellitus patients is lowest in the dorsal foot.


2020 ◽  
Vol 14 (51) ◽  
pp. 168-175
Author(s):  
Rute Nascimento Pimentel Mendes ◽  
Miréia Santana Araújo Lisboa ◽  
Thalita Pacheco de Almeida Lima

Compreende-se que o Diabetes Mellitus (DM) é uma doença crônica não transmissível com maior índice de morbidade e mortalidade, considerada um problema de saúde pública devido as suas complicações agudas e crônicas. O pé diabético ou úlcera de pés e amputação de extremidades são as complicações mais graves da DM, é uma condição clínica de alta repercussão na qualidade de vida das pessoas, seu desenvolvimento ocorre quando a circulação sanguínea é ineficaz e os níveis de açúcar são mal controlados. Objetivo: Teve como objetivo sensibilizar o cliente para o autocuidado, prevenção primária e o auxiliar ao autoexame, trazendo a consciência dos profissionais de enfermagem principalmente a importância de fazer mudanças na forma de abordagem e acolhimento desse cliente. Método: Estudo descritivo com abordagem quantitativa, realizado a partir de revisão bibliográfica, busca avançada por ano 2010 a 2017. Os dados serão selecionados da base de dados EBSCO, BIREME, SCIELO.  Resultado: Pôde-se perceber que nem sempre os portadores de diabetes mellitus (DM) conseguem identificar a gravidade da doença e as consequências que pode trazer, torna-se necessária à atuação do enfermeiro no autocuidado com o paciente diabético, o pé diabético é uma das complicações que mais vem se destacando em todo o mundo, devido ao crescente número de amputações. Às amputações pode iniciar em qualquer idade, é mais comum em pessoas com diabetes mellitus tipo 2.  Conclusão: Conclui-se que o número de amputações ainda são muito altos devido a não adesão ou abandono ao tratamento e ao nível de glicemia elevado e sustentado.   Seria necessária mais iniciativa por parte dos órgãos responsáveis, com o objetivo de capacitar os profissionais da área da para esse tipo de acolhimento, promoverem ações de sensibilização educativas, com o intuito de orientar a população quanto à doença e suas diversas formas de complicações. 


2017 ◽  
Vol 5 (8) ◽  
pp. 753-763
Author(s):  
HudaMEl Sayed ◽  
◽  
MahaA Hassan ◽  
EmadA Said ◽  
MonaN Ali ◽  
...  

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