Am Fam Physician. 2025;111(6):562-564
Author disclosure: No relevant financial relationships.
KEY POINTS FOR PRACTICE
• In patients with a suspected diabetic foot infection limited to the soft tissue, culture of a soft tissue sample should be considered instead of wound swab due to higher accuracy.
• To diagnose osteomyelitis in a patient with diabetes, a combination of probe-to-bone testing, plain radiography, and ESR, CRP, or procalcitonin levels should be considered as initial tests.
• In patients with a diabetic foot infection and suspected osteomyelitis, a bone biopsy should be considered due to poor correlation of soft tissue and bone culture results.
• Urgent surgical consultation is recommended in cases of severe or moderate diabetic foot infection complicated by extensive gangrene, necrotizing infection, deep abscess, compartment syndrome, or severe lower limb ischemia.
From the AFP Editors
Diabetic foot infections are the most frequent complication of diabetes that leads to hospitalization. They are also the most common cause of lower extremity amputation. Less than one-half of infected diabetic foot ulcers heal within 1 year, and 10% of those that heal recur. The International Working Group on the Diabetic Foot (IWGDF) and Infectious Diseases Society of America (IDSA) have published guidelines on diagnosis and treatment of these infections.
Subscribe
From $165- Immediate, unlimited access to all AFP content
- More than 130 CME credits/year
- AAFP app access
- Print delivery available
Issue Access
$59.95- Immediate, unlimited access to this issue's content
- CME credits
- AAFP app access
- Print delivery available
