Aeromonas sobria ve genişlemiş spektrumlu beta-laktamaz pozitif escherichia coli'nin etken olduğu bir Diyabetik ayak olgusu

Diyabetik ayak infeksiyonu bir sendromlar bütünüdür; bu durum tanı ve tedavide zorluklar oluşturmaktadır. Diyabetik ayak; inframalleolar bölgede gelişen, minör vasküler ve nöropatik lezyonlardan, osteomiyelit ve gangrene varan ve amputasyonla sonuçlanabilen, patogenezi karmaşık, klinik görünümü değişken bir tablodur. Diyabetik ayak infeksiyonunda risk faktörleri; diyabetin süresi, kötü ayak hijyeni, sigara, alkol kullanımı, minör travmalar, periferik nöropati, periferik anjiyopati, önceden geçirilmiş diyabetik ayak varlığı ve immün sistem bozukluğudur. Diyabetik ayak infeksiyonları çoğunlukla polimikrobiyaldir. Bu çalışmada; birçok sistemi tutan altta yatan hastalıkları olan 65 yaşında, çiftçilik yapan erkek hastada, sağ ayak dördüncü ve beşinci metatars ile sağ lateral yüzden başlayıp plantar yüze uzanan, akıntılı, derin, ülsere, yumuşak doku tutulumlu, Wagner sınıflamasına göre evre 3 olduğu saptanan; genişlemiş spekturumlu beta-laktamaz pozitif Escherichia coli ve Aeromonas sobria'nın etken olduğu, ertapenem ile tedavi edilen, multidisipliner olarak takip edilen bir diyabetik ayak olgusu sunulmuştur.

A case of Diabetic foot due to Aeromonas sobria and extended spectrum beta-lactamases positive escherichia coli

Diabetic foot has a complicated pathogenesis and is a clinically variable situation that can range from minor vascular and neuropathic lesions to osteomyelitis and necrosis, which result in amputation; this non-stable disorder appears in the inframalleolar region. The risk factors are the duration of diabetes, improper foot hygiene, minor trauma, presence of smoking and alcohol use, peripheral neuropathy, peripheral angiopathy, and history of diabetic foot and immune system deficiency. Diabetic foot infections are commonly polymicrobial. We present in this study the case of a 65-year-old male farmer with diabetic foot who had several other underlying disorders affecting several systems. Diabetic foot (right) initiated from the lateral region of the fourth and fifth metatarsals and extended to the plantar surface, and had a purulent, deep, ulcerous soft tissue involvement. The patient was evaluated as grade III according to Wagner classification with the etiology of extended spectrum beta-lactamase positive Escherichia coli and Aeromonas sobria. He is under a multidisciplinary treatment with ertapenem.

Kaynakça

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