A neglected causative agent in diabetic foot infection: a retrospective evaluation of 13 patients with fungal etiology

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Öztürk A. M. , Tasbakan M. I. , Metin D. Y. , Yener C. , Uysal S., Yıldırım Şimşir I. , ...More

TURKISH JOURNAL OF MEDICAL SCIENCES, vol.49, pp.81-86, 2019 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 49
  • Publication Date: 2019
  • Doi Number: 10.3906/sag-1809-74
  • Page Numbers: pp.81-86
  • Keywords: Invasive fungal infection, foot infection, amputation, diabetic foot ulcer, AMPUTATION, DIAGNOSIS, MELLITUS, THERAPY, ULCERS


Background/aim: Clinicians often neglect fungal infections and do not routinely investigate deep tissue from the wound for fungal

culture and sensitivity due to insufficient information in the literature. In this study, we aimed to evaluate fungal etiology of invasive

fungal diabetic foot which is rarely reported in the literature.

Materials and methods: The patients who were unresponsive to antibiotic therapy and those with positive fungal in bone or deep tissue

culture were enrolled in the study. Detailed hospital records were retrieved for demographics and clinical features.

Results: A total of 13 patients who were diagnosed with invasive fungal diabetic foot (ten females, three males, mean age 59.8 ± 9 years)

were included. All of the patients had type-2 diabetes mellitus. Eleven (84.6%) patients had mixed infection. The most common cause

of fungal infections of diabetic foot ulcers was the Candida species. Ten (76.9%) patients underwent amputation, two (15.4%) patients

refused amputation, and one patient died before surgery.

Conclusion: Invasive fungal infections may also be a causative pathogen in deep tissue infections. Therefore, fungal pathogens should

be considered in patients unresponsive to long-term antibiotic therapy. Early detection of fungal infections in high-risk individuals is

critical for the prevention of severe consequences such as foot amputation.