Ulcus Diabetica Hallucis Pedis: The Importance of Timely Treatment.

Abstract

Introduction. Diabetes mellitus represent a global problem in public health, and the incidence of diabetic foot is constantly increasing Patients with diabetes have a tendency to infections, due to previously present neuropathy, vascular insufficiency, as well as neutrophil dysfunction. The most important risk factor is the existence of peripheral neuropathy, and it is present in 30% to 50% of patients with diabetes. The foot becomes sensitive to trauma as a result of sensory, motor and autonomic dysfunction, and there is excessive pressure in the deformed foot, also the development of ischemia.

Case  report. A 59-year-ol male patient sought medical help at the Clinic of Emergency Medicine of the Clinical Center in Sarajevo. He had edematous ulcers on the foot of his right leg. On the first day of therapy, the antibiotic amoxicillin + clavulanic acid, 875/125 mf film-coated tablets were included. Ulcerative formation on the injured finger healed relatively slowly in the first five days of therapy, so from the sixth day of therapy, another broad-spectrum antibiotic per os was included, for synergistic effects: metronidazole 500 mg tablets. On the tenth day of the therapy, visible progress was observed in the healing of the injured finger. Ultimately, the treatment of the injured finger was completed routinely and successfully.

Conclusion. Identification of risk factors as well as patients’ education is an important prerequisite for the prevention of complications arising from the chronic course of diabetes.

Early initiation of treatment, with an adequate multidisciplinary approach, can cure ulcerative, inflammatory diabetic foot, which in our case corresponded to the Wagner-Meggitt classification, superficial ulcer, with a corresponding gradation 1.