Isolation of Fungi from Diabetic Foot Ulcer
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Abstract
Among all of diabetes complications, foot ulcers are at higher risk to occur, and it is estimated that 20% of hospital admissions among DM patients result from diabetic foot ulcers (DFUs). DFUs can lead to infection, gangrene, amputation, and if proper treatment is not provided, can even cause death. In fact, once a DFU is developed there is a greater risk of amputation, and it is estimated that 50–70% of all lower limb amputations (LLAs) are due to DFUs. It is predicted that in the general population (≥45 years), the incidence of vascular LLA in the diabetic is eight times higher than in non-diabetic individuals, and when it comes to the age group ≥ 85 years, the incidence in men increases to 15 times higher and 12 times higher in women than the mean incidence rates of all population groups. Most fungus like to live in a warm, moist area, and particularly on the foot they like to live in the interdigital web spaces, which lead to maceration and fungal infection between the toes. If this is left untreated it inevitably leads to breakdown in the skin leading to ulceration, allowing other pathogens a portal to set up infection. There is very little risk of pathogens infecting the superficial skin and can easily be dealt with topical antifungals, however when the fungal infection invades the deeper structures through repeated trauma it takes a whole new angle and can lead to some devastating results. Diabetic patients are a 10-fold greater risk of being admitted as a result of soft tissue or bone infection.
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