Diabetic Foot Infections

Diabetic Foot Infections


  • Plain radiographs for bony abnormalities, soft tissue gas, and radio-opaque foreign bodies

  • More advanced imaging may be required to assess extent of infection for surgical purposes; should consult an expert in managing bone and joint infections

  • Bone scan is not specific, and rarely useful

  • Send appropriately obtained specimen prior to starting empiric therapy

  • Deep tissue/bone biopsy or curettage after wound has been cleansed and debrided

  • Avoid swab specimens of superficial ulcer, especially of inadequately debrided wounds


  • Check for peripheral pulses and necrotic tissue

  • Vascular surgery consult if ischemia or absent pulses

  • Ankle-brachial index (ABI) for non-urgent vascular assessment

Diabetes optimization

  • Consult the wound care nurse

Consider ID consult for moderate to severe infections

Urgent orthopedic surgery consult if DFI accompanied by gas, abscess, or necrotizing fasciitis