Indian Journal of Endocrinology and Metabolism

ORIGINAL ARTICLE
Year
: 2016  |  Volume : 20  |  Issue : 5  |  Page : 619--624

The clinical and microbiological profile of the diabetic hand: A retrospective study from South India


Sreekanth Raveendran1, Dukhabandhu Naik2, Samuel C Raj Pallapati1, John Jude Prakash3, Binu Prathap Thomas1, Nihal Thomas2 
1 Dr. Paul Brand Centre for Hand Surgery, Christian Medical College, Vellore, Tamil Nadu, India
2 Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India
3 Department of Microbiology, Christian Medical College, Vellore, Tamil Nadu, India

Correspondence Address:
Nihal Thomas
Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore - 632 004, Tamil Nadu
India

Background: Pyogenic Infections of the hand in diabetes are largely a tropical entity and published material in the area are rather meagre. Patients and Methods: This is a retrospective study on the pattern of hand infections and involves the microbiological profile of 39 cases of diabetes hand-related infections admitted to the hospital between the years 2004 and 2010. Results: This study included 39 patients, among whom 23 (59%) had necrotizing fasciitis (NF), and 16 (9-abscess and 7-tenosynovitis) had nonnecrotizing infection. Among 25 culture positive patients, polymicrobial infections were isolated in 13 (52%) patients, a single organism was isolated in 9 (36%) and 3 (12%) had sterile cultures. Out of the 41 different bacterial isolates, 51.12% were Gram-negative and 48.78% were Gram-positive. Patients with NF had a higher mean glycated hemoglobin (10.83 ± 2.59 vs. 8.64 ± 1.8%, P = 0.020), when compared to the nonnecrotizing group. Patients with NF also had more polymicrobial infections (P = 0.017), and a longer duration of hospitalization when compared to patients without NF (21.8 ± 9.96 vs. 12.7 ± 14.5 days, P = 0.021). Seven (17.94%) patients required amputation of the affected digits of which six (15.38%) had NF. Conclusion: Patients with poor glycemic control, polymicrobial infection, delay in presentation, and a prior surgical intervention at another medical center was associated with more severe necrotizing infections. The duration of hospitalization and amputation rates was greater among patients with NF.


How to cite this article:
Raveendran S, Naik D, Raj Pallapati SC, Prakash JJ, Thomas BP, Thomas N. The clinical and microbiological profile of the diabetic hand: A retrospective study from South India.Indian J Endocr Metab 2016;20:619-624


How to cite this URL:
Raveendran S, Naik D, Raj Pallapati SC, Prakash JJ, Thomas BP, Thomas N. The clinical and microbiological profile of the diabetic hand: A retrospective study from South India. Indian J Endocr Metab [serial online] 2016 [cited 2021 Jan 18 ];20:619-624
Available from: https://www.ijem.in/article.asp?issn=2230-8210;year=2016;volume=20;issue=5;spage=619;epage=624;aulast=Raveendran;type=0