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==Overview==
==Overview==
[[Diabetic foot]] is classified according to it's severity and factors such as requirement of [[mouth|oral]] or [[Route of administration|parenteral]] [[antibiotics]], outpatient management or [[Hospital|hospitalization]], and [[surgery|surgical intervention]].
[[Diabetic foot]] is classified according to its severity and factors such as the requirement of [[mouth|oral]] or [[Route of administration|parenteral]] [[antibiotics]], outpatient management or [[Hospital|hospitalization]], and [[surgery|surgical intervention]].


==Classification==
==Classification==
[[Diabetic foot]] [[infections]] are classified according to the severity of involvement to assist with clinical decision making regarding need for [[mouth|oral]] or [[Route of administration|parenteral]] [[antibiotics]], outpatient management or [[Hospital|hospitalization]], and [[surgery|surgical intervention]]. The Infectious Disease Society of America (IDSA) introduced a classification scheme for these [[infections]] in their 2004 guidelines, broadly categorized as mild, moderate, and severe [[infections]] based upon the extent of [[infection]] and [[inflammation]].<ref name="pmid22619242">{{cite journal| author=Lipsky BA, Berendt AR, Cornia PB, Pile JC, Peters EJ, Armstrong DG et al.| title=2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. | journal=Clin Infect Dis | year= 2012 | volume= 54 | issue= 12 | pages= e132-73 | pmid=22619242 | doi=10.1093/cid/cis346 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22619242}} </ref>  
[[Diabetic foot]] [[infections]] are classified according to the severity of involvement to assist with clinical decision-making regarding the need for [[mouth|oral]] or [[Route of administration|parenteral]] [[antibiotics]], outpatient management or [[Hospital|hospitalization]], and [[surgery|surgical intervention]]. The Infectious Disease Society of America (IDSA) introduced a classification scheme for these [[infections]] in their 2004 guidelines, broadly categorized as mild, moderate, and severe [[infections]] based upon the extent of [[infection]] and [[inflammation]].<ref name="pmid22619242">{{cite journal| author=Lipsky BA, Berendt AR, Cornia PB, Pile JC, Peters EJ, Armstrong DG et al.| title=2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. | journal=Clin Infect Dis | year= 2012 | volume= 54 | issue= 12 | pages= e132-73 | pmid=22619242 | doi=10.1093/cid/cis346 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22619242}} </ref>  
*The International Working Group on the [[Diabetic Foot]] (IWGDF) published a similar classification system in 2012.<ref name="pmid22271739">{{cite journal|author=Lipsky BA, Peters EJ, Senneville E, Berendt AR, Embil JM, Lavery LA, Urbancic-Rovan V, Jeffcoate WJ|title=Expert opinion on the management of infections in the diabetic foot.|journal=Diabetes Metab Res Rev|year=2012|volume=28|issue=1|pages=163-78|pmid=22271739|doi=|url=http://www.ncbi.nlm.nih.gov/pubmed/22271739}}</ref>  
*The International Working Group on the [[Diabetic Foot]] (IWGDF) published a similar classification system in 2012.<ref name="pmid22271739">{{cite journal|author=Lipsky BA, Peters EJ, Senneville E, Berendt AR, Embil JM, Lavery LA, Urbancic-Rovan V, Jeffcoate WJ|title=Expert opinion on the management of infections in the diabetic foot.|journal=Diabetes Metab Res Rev|year=2012|volume=28|issue=1|pages=163-78|pmid=22271739|doi=|url=http://www.ncbi.nlm.nih.gov/pubmed/22271739}}</ref>  
*The aforementioned systems were externally validated in a longitudinal study to assess [[Prognosis|prognostic value]], which demonstrated increased risk for [[amputation]] among [[patients]] with [[infections]] classified as severe.<ref name="pmid17243061">{{cite journal|author=Lavery LA, Armstrong DG, Murdoch DP, Peters EJ, Lipsky BA|title=Validation of the Infectious Diseases Society of America's diabetic foot infection classification system.|journal=Clin Infect Dis|year=2007|volume=44|issue=4|pages=562-5|pmid=17243061|doi=|url=http://www.ncbi.nlm.nih.gov/pubmed/17243061}}</ref>
*The aforementioned systems were externally validated in a longitudinal study to assess [[Prognosis|prognostic value]], which demonstrated increased risk for [[amputation]] among [[patients]] with [[infections]] classified as severe.<ref name="pmid17243061">{{cite journal|author=Lavery LA, Armstrong DG, Murdoch DP, Peters EJ, Lipsky BA|title=Validation of the Infectious Diseases Society of America's diabetic foot infection classification system.|journal=Clin Infect Dis|year=2007|volume=44|issue=4|pages=562-5|pmid=17243061|doi=|url=http://www.ncbi.nlm.nih.gov/pubmed/17243061}}</ref>
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[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Endocrinology]]
[[Category:Endocrinology]]
[[Category:Needs English Review]]
[[Category:Up-To-Date]

Revision as of 20:10, 19 February 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Daniel A. Gerber, M.D. [2]

Overview

Diabetic foot is classified according to its severity and factors such as the requirement of oral or parenteral antibiotics, outpatient management or hospitalization, and surgical intervention.

Classification

Diabetic foot infections are classified according to the severity of involvement to assist with clinical decision-making regarding the need for oral or parenteral antibiotics, outpatient management or hospitalization, and surgical intervention. The Infectious Disease Society of America (IDSA) introduced a classification scheme for these infections in their 2004 guidelines, broadly categorized as mild, moderate, and severe infections based upon the extent of infection and inflammation.[1]

  • The International Working Group on the Diabetic Foot (IWGDF) published a similar classification system in 2012.[2]
  • The aforementioned systems were externally validated in a longitudinal study to assess prognostic value, which demonstrated increased risk for amputation among patients with infections classified as severe.[3]
Clinical Manifestation PEDIS Grade IDSA Severity
No symptoms or signs of infection 1 Uninfected
Local infection involving only the skin and the subcutaneous tissue without involvement of deeper tissues and without signs of SIRS 2 Mild
Local infection with erythema >2 cm or involving structures deeper than skin and subcutaneous tissues (eg, abscess, osteomyelitis, septic arthritis, fasciitis) without signs of SIRS 3 Moderate
Local infection with the signs of SIRS, as manifested by ≥2 of the following: 4 Severe

References

  1. Lipsky BA, Berendt AR, Cornia PB, Pile JC, Peters EJ, Armstrong DG; et al. (2012). "2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections". Clin Infect Dis. 54 (12): e132–73. doi:10.1093/cid/cis346. PMID 22619242.
  2. Lipsky BA, Peters EJ, Senneville E, Berendt AR, Embil JM, Lavery LA, Urbancic-Rovan V, Jeffcoate WJ (2012). "Expert opinion on the management of infections in the diabetic foot". Diabetes Metab Res Rev. 28 (1): 163–78. PMID 22271739.
  3. Lavery LA, Armstrong DG, Murdoch DP, Peters EJ, Lipsky BA (2007). "Validation of the Infectious Diseases Society of America's diabetic foot infection classification system". Clin Infect Dis. 44 (4): 562–5. PMID 17243061.

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