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Table 1: Classification for Diabetic Foot Infection: American Society for Infectious Diseases and the International Group on Diabetic Foot. |
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Clinical manifestations of infection |
PEDIS |
IDSA |
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No symptoms or signs |
1 |
Not infected |
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Infection present: defined as the presence of at least two signs: • Erythema • Local pain • Local increase in temperature • Purulent discharge |
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Local infection involving only the skin and subcutaneous cellular tissue (without involving deep tissues and without systemic involvement). The erythema should be 5 mm to 2 cm around the ulcer; rule out Charcot foot, fracture, thrombosis, venous stasis, trauma and gout |
2 |
Mild |
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Local infection (see above) with erythema greater than 2 cm or involving deep structures (fasciitis, osteomyelitis, septic arthritis, abscess) and without systemic inflammatory response syndrome |
3 |
Moderate |
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Local infection (see above) with systemic inflammatory response syndrome (temperature less than 36 oC or greater than 38 oC, heart rate greater than 90 BPM, respiratory rate greater than 20 RPM or PaCO2 less than 32 mmHg, leukocytes greater than 12,000 or less 4,000 cels/ml or more than 10% of immature cells or left shift) |
4 |
Severe |
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Ischemia can increase the severity of the infection. Severe ischemia is considered a severe infection Systemic infection can be accompanied by failure of other organs Abbreviations: IDSA (Infectious Diseases Society of America) PaCO2: arterial CO2 partial pressure. |
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