Clinical characteristics of diabetic patients with upper limb and hand infections
F Muhamad Effendi, MF Miswan, MI Ibrahim, KN Rozali, MS,
Faculty Of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
ABSTRACT
Introduction: Patients with diabetes mellitus (DM) have an increased risk of infection resulting from neuropathy, vasculopathy and immunosuppression. Literature regarding infections of the hands and upper limb among patients with DM is limited. Furthermore, hand and upper limb infection are being recognised as a significant cause of morbidity and mortality. The purpose of this study is to investigate the clinical characteristics and surgical outcomes of upper limb infections in patients with DM. Materials and Method: A retrospective review of 18 months’ duration of patients with DM admitted for hand and upper limb infections. Results: A total of 21 patients with average age of 49.7 years (range 16-79) were included in the analysis, of which 15 (71%) were females. Six (29%) were newly diagnosed DM. The average Glycosylated Haemoglobin (HbA1C) level was high for both newly diagnosed and known DM, at 10.4% and 10.7% respectively. Patients presented on average of 10 days after onset of symptoms. Thirteen (62%) presented with abscess and the most common site of involvement was the hands. Culture studies revealed Klebsiella spp., Escherichia coli spp. and Staphylococcus aureus as the most common organism isolated. Three patients required amputation or joint disarticulation. Sixteen patients (76%) had good outcome at three months follow up. Conclusion: Poor glycemic control, duration of diabetes and delayed presentation were the main risk factors in diabetic patients presenting with severe infection of hands and upper limbs. In majority of patients, antibiotics and surgical treatment results in good outcome.
Keywords: Infections, upper limb, diabetes mellitus, sepsis, complications
Correspondence author: F Muhamad Effendi. Department of Orthopaedics, Faculty of Medicine, Universiti Teknologi MARA, Sg. Buloh Campus, Jalan Hospital, 47000, Sg Buloh, Selangor Malaysia.
Tel: +60192164800, E mail: ferdhany@yahoo.com
Brunei Int Med J.
2016;
12 (1): 26-31