The value of inflammatory markers to diagnose and monitor diabetic foot
osteomyelitis.
Authors Van Asten SA, Nichols A, La Fontaine J, Bhavan K, Peters EJ, Lavery LA
Submitted By Lawrence Lavery on 2/20/2018
Status Published
Journal International wound journal
Year 2017
Date Published 2/1/2017
Volume : Pages 14 : 40 - 45
PubMed Reference 26634954
Abstract In this study, we assessed the effectiveness of inflammatory markers to diagnose
and monitor the treatment of osteomyelitis in the diabetic foot. We evaluated 35
consecutive patients admitted to our hospital with infected foot ulcers.
Patients were divided in two groups based on the results of bone culture and
histopathology: osteomyelitis and no osteomyelitis. The erythrocyte
sedimentation rate (ESR), C-reactive protein (CRP), procalcitonin (PCT),
interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor alpha (TNFa),
monocyte chemotactic protein-1 (MCP-1) and macrophage inflammatory protein-1
alpha (MIP1a) were measured at baseline after 3 and 6 weeks of standard therapy.
PCT levels in the osteomyelitis group were significantly higher at baseline than
in the group with no osteomyelitis (P = 0·049). There were no significant
differences between the two groups in the levels of the other markers. CRP, ESR,
PCT and IL-6 levels significantly declined in the group with osteomyelitis after
starting therapy, while MCP-1 increased (P = 0·002). TNFa and MIP1a levels were
below range in 80 out of 97 samples and therefore not reported. Our results
suggest that PCT might be useful to distinguish osteomyelitis in infected foot
ulcers. CRP, ESR, PCT and IL-6 are valuable when monitoring the effect of
therapy.

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