Negligent glycemic control and clinical decision-making concerns: A case report on the progression of a simple hand wound to cellulitis

Year 2024, Volume: 41 Issue: 2, 429 - 431, 19.05.2024

Srinivasa Rao Yarguntla , Vinodkumar Mugada , Satya Sai Sri Narava

Abstract

Diabetes Mellitus is recognized for its increased vulnerability to infections, notably cellulitis. This report presents a case of a 35-year-old male with a history of type 2 diabetes since 2020. Following a minor bike accident, the patient's wound culminated in cellulitis due to unmanaged diabetes and possible medical oversight. Initially treated with tetanus toxoid and dusting powder, the wound was exacerbated after a week, revealing pus and substantial swelling. Despite medical consultation, the absence of antibiotics led to a progression in symptoms and hospital admission. Elevated blood sugar levels were evident with an HbA1c of 8.5%. Subsequent therapeutic interventions, including incisional drainage and intensive antibiotic therapy, led to stabilization. This case underscores the importance of vigilant wound management and therapeutic intervention in diabetic patients, emphasizing timely antibiotic administration to prevent complications.

Keywords

diabetes mellitus , cellulitis , HbA1c , piperacillin and tazobactam

Ethical Statement

The case report does not require an ethical committee approval. We obtained a written informed consent from the patient

Thanks

We are grateful for department of General Surgery, Visakha Institute of Medical Sciences, Hanumanthuwaka, Visakhapatnam, AP, India

References

• Zhou K, Lansang CM. Diabetes Mellitus, and Infections. Endotext [Internet] 2021. South Dartmouth (MA): MDText.com, Inc.; 2000-.Availablefrom:https://www.ncbi.nlm.nih.gov/books/NBK569326/
• Carey IM, Critchley JA, DeWilde S, Harris T, Hosking FJ, Cook DG. Risk of Infection in Type 1 and Type 2 Diabetes Compared with the General Population: A Matched Cohort Study. Diabetes care. 2021; 41(3):513–521.
• Zacay G, Hershkowit Sikron F, Heymann AD. Glycemic Control and Risk of Cellulitis. Diabetes care. 2021;44(2):367–372.
• Critchley JA, Carey IM, Harris T, DeWilde S, Hosking FJ, Cook DG. Glycemic Control and Risk of Infections Among People with Type 1 or Type 2 Diabetes in a Large Primary Care Cohort Study. Diabetes care. 2018; 41(10): 2127–2135.
• American Diabetes Association. Glycemic Targets: Standards of Medical Care in Diabetes—2020. Diabetes Care. 2020 ;43(Supplement 1):S66-S76.
• Kumar A, Arora A, Sharma P, Anikhindi SA, Bansal N, Singla V, Khare S, Srivastava A. Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis. Diabetes & metabolic syndrome. 2020; 14(4):535–545.
• Zumla A. Mandell, Douglas, and Bennett's principles and practice of infectious diseases. The Lancet. Infectious Diseases. 2010; 10(5):303–304.
• Product Information: Amoxicillin sodium potassium clavulanate IV injection, amoxicillin sodium potassium clavulanate IV injection. Sandoz Canada Inc (per manufacturer), Boucherville, Quebec, 2021.
• Product Information: ZOSYN(R) intravenous injection, piperacillin tazobactam intravenous injection. Wyeth Pharmaceuticals LLC (per FDA), Philadelphia, PA, 2020.