Signs and symptoms

Diabetic foot infections typically take one of the following forms:

• Cellulitis
• Deep-skin and soft-tissue infections
• Acute osteomyelitis
• Chronic osteomyelitis

Cellulitis

• Tender, erythematous, nonraised skin lesions are present, sometimes with lymphangitis
• Lymphangitis suggests group A streptococcal infection
• Bullae are typical of Staphylococcus aureus infection, but occasionally occur with group A streptococci

· No ulcer or wound exudate is present

Deep-skin and soft-tissue infections

• The patient may be acutely ill, with painful induration of the soft tissues in the extremity
• Wound discharge is usually not present
• In mixed infections that may involve anaerobes, crepitation may be noted over the afflicted area
• Extreme pain and tenderness may indicate compartment syndrome or clostridial infection (ie, gas gangrene)
• The tissues are not tense, and bullae may be present
• Discharge, if present, is often foul