Infections in diabetes

Diabetes means higher risk to all forms of diseases. Diabetics are also highly prone to infections. Uncontrolled diabetes rapidly promotes infection. This is so because sugar in the blood is a good media for rapid and abundant growth of organisms and at the same time infection itself disturbs the blood sugar levels and may precipitate ketoacidosis. The occurrence of infection then perpetuates a vicious cycle in which infection results in uncontrolled blood sugar which in turn causes further aggravation of infections. Such infections risk complications and morbidity in diabetics more than they would for a normal person.

Some infections commonly seen in diabetics are –

Rhinocerebral Mucormycosis

-Mucormycosis is caused due to the inhalation of spores. This is basically a fungal infection that affects the nose and the brain, hence its called Rhinocerebral Mucormycosis. It typically affects diabetics whose immune system is weak due to uncontrolled diabetes. It causes fever, cough and breathing difficulty and when it reaches the brain it may cause seizures, partial paralysis and coma.

Malignant Otitis Externa

-Otitis Externa is an inflammation of the outer ear and the skin of the ear canal. It is commonly known as Earache or Swimmer”s Ear. The ear canal skin swells and may become painful and tender to touch. Diabetics are highly prone to the serious form of external otitis called malignant or necrotizing external otitis. In this form, the infection extends beyond the confines of the ear canal and can involve even the bone and the skull which can make the infection fatal for diabetics.

Emphysematous Pyelonephritis

-It is a rare life-threatening upper urinary tract infection associated with the formation of gas within the kidney and perinephric space. It results in loin pain, fever, systemic upset and urinary tract symptoms causing severe disturbance of glycemic control.

Emphysematous Cholecystitis

-Its an acute infection of the gall bladder caused by presence of gas in the lumen of the gall bladder as well as in its walls and adjacent tissues, in absence of abnormal communication among the digestive and biliary system. This gas is produced by the anaerobic bacteria like Klesiella, Staphylococcus, Streptococcus, and pseudomanas species that invade the organ”s mucosa. The bacteria colonize the gall bladder via the bloodstream, lymphatics or through the bile itself.

Acute Necrotizing fasciitis

-This is commonly known as “flesh-eating bacteria”. It is a rare infection of the deeper layers of the skin and subcutaneous tissues. The bacteria cause destruction of the skin and muscle by releasing toxins. Bacteria like Group A streptococcus, Vibrio vulnificus, Clostridium perfringens, Bacteroides fragilis), of which Group A streptococcus is the most common cause.

The infection begins at a site of severe trauma minor, or even non-apparent. The affected skin is becomes very painful without obvious change. Later as the disease progresses the tissue swells up. Sometimes diarrhea and vomiting appear to be the visible symptoms as the inflammation doesn”t show signs straight away. If the infection is not very deep, signs such as redness, swelling and hot skin show quite early. Skin color can turn to violet and blisters may form eventually leading to the death of the subcutaneous tissues.

Diabetics with necrotizing fasciitis typically have a fever and appear quite ill. More severe cases the infection progresses within hours.  Even with if they are administered antibiotics, it takes a great deal of time to react to the bacteria. This slow reaction allows the infection to progress to a more serious state. That is why the mortality rate is high as about 30% in such cases.