A ''not so superficial" skin infection in a patient with diabetes. (30th October 2012)

• Record Type: Journal Article
• Authors: Carr, James Michael; Hagan, Guy; Guest, Peter; Gompertz, Simon
• Is Part Of: BMJ case reports. Volume 2012
• Publication Date: 2012-10-30
• Subjects: Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2012-007062
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : A woman in her 60s with type 2 diabetes presented with a 4-week history of a rash on her chest wall, flu-like symptoms and a red right eye. On examination, there was a cellulitic rash over the right chest wall, breast and neck and a hypopyon in the right eye. Chest x-ray demonstrated right upper lobe opacification, with subsequent CT and MRI revealing bilateral collections at the lung apices, and a possible permeative bone destruction of the manubrium, respectively. A diagnosis of primary sternal osteomyelitis with associated lung abscesses, chest wall cellulitis and hypopyon due to endogenous endophthalmitis was made, with microbiological assessment identifying group B β-haemolytic streptococci. The patient underwent surgical debridement of the affected tissue and received 6 weeks of intravenous antibiotics. This case highlights the role of multidisciplinary team involvement in management of infections and the need to consider deep-seated infection in diabetics.