Successful nonsurgical therapy of a diabetic foot osteomyelitis in a patient with peripheral artery disease with almost complete radiological restoration

• Published in: BMC research notes 2018-08, Vol.11 (1), p.579-579, Article 579
• Main Authors: Loupa, C V, Meimeti, E, Voyatzoglou, E, Donou, A, Koutsantoniou, E, Lafoyanni, S
• Format: Article
• Language: English
• Subjects: Aged; Amputation; Angioplasty; Anti-Bacterial Agents - therapeutic use; Antibiotics; Blood; Blood flow; Care and treatment; Case Report; Cellulitis; Ciprofloxacin; Clindamycin; Complications and side effects; Diabetes; Diabetes mellitus; Diabetic foot; Diabetic Foot - complications; Diabetic foot infection; Drug resistance; Feet; Foot diseases; Greece; Hospitalization; Hospitals; Humans; Infectious diseases; Inflammation; Intravenous administration; Leg ulcers; Male; Medical diagnosis; Methicillin; Methicillin-Resistant Staphylococcus aureus; Osteomyelitis; Osteomyelitis - etiology; Osteomyelitis - therapy; Patients; Peripheral Arterial Disease; Peripheral artery disease; Peripheral vascular diseases; Risk factors; Staphylococcus aureus; Staphylococcus infections; Stenotrophomonas maltophilia; Vascular diseases; X-rays
• ISSN: 1756-0500; 1756-0500
• DOI: 10.1186/s13104-018-3694-x

Diabetic foot ulcer (DFU) is a common complication in patients with diabetes mellitus (DM) and can consequently lead to soft tissue infection and osteomyelitis. We present a case of a 68-year-old man with a history of Type 2 DM and symptomatic peripheral artery disease, referred to our hospital due to an infected lower extremity DFU. Cultures revealed methicillin-resistant Staphylococcus aureus and Stenotrophomonas maltophilia. There was a significant increase of inflammatory marker levels and plain X-rays revealed osteomyelitis. He underwent lower extremity angioplasty for the restoration of the blood flow. He received targeted intravenous antibiotic therapy for 2 weeks and continued ciprofloxacin along with clindamycin per os for 10 more weeks as outpatient. As a result, the patient presented almost complete healing of his DFU, reconstruction of osteomyelitis defects in X-ray and complete restoration of his foot functionality only 4 months after the end of the treatment. This case demonstrates a DFU complicated by osteomyelitis which resolved medically and nonsurgically, with the exception of surgical restoration of the blood flow.