Hand Infections among Patients with Diabetes in Abidjan, C?te d’Ivoire: Epidemiological Characteristics, Clinical Presentation, and Therapeutic Management
Objective: To investigate the factors associated with hand infections among people with diabetes in Abidjan. Method: This was a descriptive cross-sectional study with an analytical focus, conducted over a five-year period (January 2019 to December 2023) and based on the medical records of diabetic patients treated for hand infections. Results: The hospital incidence of hand infections in diabetic patients in Abidjan is 0.27% (30/10,912). There was a predominance of female patients (83%) and a mean age of 49.03 ± 12.39 years. The most common occupational groups were manual workers, particularly those in the informal sector (53%), farmers (7%) and housewives (23%). A hand infection led to the diagnosis of diabetes in 30% of cases. Diabetes was type 2 in 93% of cases and had been present for an average of 4.67 years. The average blood glucose level was 2.86 g/L. Hand involvement was the result of trauma in 40% of cases and had been present for an average of 25.10 days. The lesions affected the dominant hand in the majority of cases and were classified as follows: Ulceration (14 cases), Phlegmons (10 cases), Whitlow (8 cases), Gangrene (7 cases), Necrosis (6 cases), Abscess (1 case). The causative organisms were Klebsiella pneumoniae and Staphylococcus aureus. Amputation was unavoidable in 8 cases (26.7%). Incision and drainage were the main surgical procedures used in 10 cases (33.3%). Disarticulation was performed in eight cases (23.3%). Surgical treatment was indicated for gangrene (100%) and necrosis (50%). Conclusion: The management of hand infections in diabetic patients must be early and multidisciplinary. Delayed consultation and the severity of the lesions can lead to sequels.
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