Abstract:
Objective: Diabetes mellitis, when chronic and uncontrolled, is undeniably associated with myriad health complications, most importantly immune dysfunction and healing abnormalities. Th e ensuing tissue injury and the inef ective healing, particularly in the foot, is oft en compounded by bacterial and fungal infections, which predispose to the development of infected diabetic foot ulcer (DFU) - a grave complication ending up in foot amputation in signifi cant number of patients. Th is study assesses the prevalence and pat ern of dermatophytes in diabetic foot ulcer. Material and Methods: In this study we included a total of 298 diabetic patients with diabetic foot ulcers who presented to JPMC from June 2019 till June 2020. We recorded their demographic features and blood glucose level at the time of sample taking. Th e foot ulcers were graded according to Wagner/ Meggit ulcer grading scale. Taking aseptic measures, samples were taken from the ulcers and skin at the ulcers edge and, processed and interpreted according to standard guidelines. Results: Fungal positivity was more in men (61%) than women (39%). Overall mean age (± SD) was 50.0(± 8.1) years. On fungal culture, total fungus positive cases were 92 (30.9%) out of which 49 (53%) were dermatophytes (p<0.01). Prevalence of dermatophytes in the DFU (tinea pedis) of population studied was found to be 16.44%. Th e most frequently isolated species was Tinea rubrum (43%) followed by Tinea mentagrophytes (29%). Conclusion: Th is study showed that dermatophytes are associated with Diabetic Foot Ulcer in signifi cant number of cases. Specifi c antifungals must be prescribed to treat dermatophyte infection (tinea pedis) and prevent its most horrendous complication, foot amputation. Th is is only possible when a high clinical suspicion is supported by timely and appropriate screening for fungi, such as dermatophytes, especially, when lesions are refractory to repeated anti-bacterial therapy.
Page(s):
259-264
DOI:
DOI not available
Published:
Journal: Pakistan Journal of Surgery, Volume: 37, Issue: 4, Year: 2021
Keywords:
Diabetic foot ulcer
,
Dermatophytoses
,
Diabetic complications
,
Wagner Meggit ulcer grading scale tinea pedis