Successful nonsurgical therapy of a diabetic foot osteomyelitis in a patient with peripheral artery disease with almost complete radiological restoration

摘要

Abstract BackgroundDiabetic foot ulcer (DFU) is a common complication in patients with diabetes mellitus (DM) and can consequently lead to soft tissue infection and osteomyelitis.Case presentationWe present a case of a 68-year-old man with a history of Type 2 DM and symptomatic peripheral artery disease, referred to our hospital due to an infected lower extremity DFU. Cultures revealed methicillin-resistant Staphylococcus aureus and Stenotrophomonas maltophilia . There was a significant increase of inflammatory marker levels and plain X-rays revealed osteomyelitis. He underwent lower extremity angioplasty for the restoration of the blood flow. He received targeted intravenous antibiotic therapy for 2?weeks and continued ciprofloxacin along with clindamycin per os for 10 more weeks as outpatient.ConclusionAs a result, the patient presented almost complete healing of his DFU, reconstruction of osteomyelitis defects in X-ray and complete restoration of his foot functionality only 4?months after the end of the treatment. This case demonstrates a DFU complicated by osteomyelitis which resolved medically and nonsurgically, with the exception of surgical restoration of the blood flow.