Diabetes mellitus (DM) is a highly prevalent disease in modern societies, most of the times being either inappropriately treated or not treated at all. Though generally considered to be an independent risk factor for the occurrence and severity of infections in general, DM has not been clinically proven to have any strong association with infection. There are, however, certain infections that are more common in DM, sometimes with a less favorable course than in non-diabetics. Other types of infection affect almost exclusively patients with DM. Experimentally, DM patients have a depressed neutrophil activity, a less effective cell mediated immunity, altered antioxidant systems and diminished interleukin synthesis. Regarding common infections, those affecting the respiratory tract have not been proven to be more serious in DM patients, with the exception of S. pneumoniae infections - thus the recommendation to vaccinate them against pneumococcus and influenza. As for urinary tract infections, bacteriuria takes place more commonly in women with DM, more frequently complicated by pyelonephritis, papillary necrosis, xanthogranulomatous pyelonephritis and gangrenous cystitis/ pyelonephritis. Periodontitis and soft-tissue infections are also more common in DM. Each specific infection is associated with typical microbes, and their knowledge is essential for an appropriate initial treatment. The nearly exclusively DM-related infections include malignant external otitis, rhinocerebral mucormycosis, gangrenous cholecystitis, and the sum of alterations referred to as "diabetic foot". The general knowledge of these infections assumes great importance since they often require a multidisciplinary approach, involving endocrinologists, infectologists, nephrologists and vascular surgeons, among others.
Diabetes mellitus; Infection; Diabetic foot; Urinary tract infections; Antibiotics; Soft tissue infections
