Classification of Diabetic Foot Infections

 

Patient selection: diabetic with wound on foot

 

Parameters:

(1) local signs of inflammation or minor infection

(2) local signs of significant infection or complications

(3) systemic signs of the inflammatory response

Inflammation or Minor Infection	Local Signs of Significant Infection	Systemic Findings	IDSA	IWGDF
none	none	none	uninfected	1
>= 2	none	none	mild	2
NA	>= 1	none	moderate	3
NA	>= 1	present	severe	4

 

where:

• The presence of a single local sign of inflammation does not fit into a category. I will use an intermediate level (between IWGDF 1 and 2; minimal for IDSA)

 

Local signs of inflammation or minor infection:

(1) purulence or erythema <= 2 cm around the wound

(2) pain

(3) tenderness

(4) warmth

(5) induration

Any infection is limited to skin or superficial subcutaneous tissue

 

Local signs of significant infection or complications:

(1) cellulitis > 2 cm around the wound

(2) lymphangitis

(3) spread beneath fascia

(4) deep tissue abscess

(5) gangrene

(6) muscle, tendon, joint and/or bone involvement (including osteomyelitis)

 

Systemic findings of infection:

(1) fever

(2) chills

(3) tachycardia

(4) hypotension

(5) confusion

(6) vomiting

(7) leukocytosis

(8) acidosis

(9) hyperglycemia

(10) azotemia