title: Leukocytosis is a poor indicator of acute osteomyelitis of the foot in diabetes mellitus.
abstract: The purpose of this article is to describe the frequency of leukocytosis and elevated erythrocyte sedimentation rate in a series of diabetics with acute foot infections and osteomyelitis due to neuropathic foot ulcerations. The authors reviewed the admission records of 28 type II diabetic patients admitted to University Hospital in San Antonio, Texas between January 1, 1990 and December 30, 1992 with acute osteomyelitis of the foot secondary to neuropathic ulceration. The mean white blood cell count on admission for all subjects studied was calculated at 11.9 +/- 5.4 x 10(3) cells/mm3. Of all white blood cell counts collected for patients admitted with acute osteomyelitis of the foot, 54% were within normal limits. Erythrocyte sedimentation rate was elevated in 96% of patients. Oral temperature was normal in 82% of patients. The authors conclude that a normal white cell count should not deter one from taking appropriate action to mitigate the propagation of a potentially limb-threatening foot infection.
authors.affiliation: Department of Orthopedics, University of Texas Health Science Center at San Antonio, USA.
authors.forename: D G
authors.initials: DG
authors.lastname: Armstrong
authors.forename: L A
authors.initials: LA
authors.lastname: Lavery
authors.forename: M
authors.initials: M
authors.lastname: Sariaya
authors.forename: H
authors.initials: H
authors.lastname: Ashry
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D001799:Blood Sedimentation; D048909:Diabetes Complications; D017719:Diabetic Foot / Q000150:complications*; D005260:Female; D006801:Humans; D007964:Leukocytosis / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000150:complications / Q000175:diagnosis; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity