𝔖 Bobbio Scriptorium
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Fatal Hand Sepsis in Tanzanian Diabetic Patients

✍ Scribed by Archibald, L.K.; Gill, G.V.; Abbas, Z.


Publisher
John Wiley and Sons
Year
1997
Tongue
English
Weight
420 KB
Volume
14
Category
Article
ISSN
0742-3071

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✦ Synopsis


Hand infections are common presentations among diabetic patients admitted to hospital in Tanzania. The morbidity and mortality are high and patients' hospital inpatient stay tend to be prolonged because of suboptimal therapy.We describe four diabetic patients with hand infections and fatal outcomes. In contrast to patients with foot infections, none of our patients had clinical evidence of peripheral neuropathy or vascular disease. All four patients eventually died in hospital after acquiring hand sepsis and diabetic ketoacidosis which did not respond to prolonged courses of intravenous insulin and antimicrobials. Literature review suggests such infections are at least as likely to include Gram-negative organisms as Staphylococcus aureus. Primary management should have included aggressive surgery with limb amputation if necessary with adjunctive antimicrobial therapy.