Complicated diabetic foot and multidisciplinary management: a case report from iatrogenesis to resolution

Abstract

Diabetic foot infections, or diabetes-related foot disease (DRFD), represent one of the leading causes of emergency hospital admissions among patients with diabetes and often precede unfavorable outcomes such as amputations. These complications may be associated with iatrogenic initial management, which can be prevented or mitigated through an appropriate multidisciplinary approach. We report the case of an 80-year-old male patient with type 2 diabetes mellitus, well controlled with oral antidiabetic agents, who developed tissue necrosis following a laceration of the second toe of the left foot. Upon seeking care at his local Primary Health Unit, he underwent an amputation of the affected region under suboptimal aseptic and antiseptic conditions, performed by a non-specialist physician, which resulted in severe forefoot infection and sepsis. This evolution prompted an orthopedic consultation and subsequent transmetatarsal amputation. From that point onward, with the implementation of well-established multidisciplinary strategies, the clinical outcome was satisfactory. This case illustrates a peculiar situation, in which an initial iatrogenic intervention evolved favorably after appropriate multidisciplinary management was instituted.