September 19, 2001
Complications
Question from the United Kingdom:
My mother has insulin treated diabetes and MRSA, and recently, her little toe on one foot was recently “snapped off” after a period of time (not a surgical or anaesthetised procedure). She now has been told she has MRSA in the big toe on the same foot, which is very black and has an extremely bad odour, She is in severe pain and takes a lot of medication for it. We seem to be just waiting.
I am so upset because I do not know why this has happened or if it is dangerous (I assume toes falling off is not a healthy sign). Should I be worried? Is the MRSA a result or made more likely by her diabetes? Can this spread? Can I tell if this is really diabetic gangrene?
I am so desperate for information, but our hospital seems content to let my mother go through endless drug treated agony and no drugs are being administered for the actual infection! She is now bedridden and I am at my wits’ end.
Answer:
Patients with diabetes have an increased risk of amputation, especially digits on the lower extremities. Infection is common when the toes turn black. They can be infected with the bacterium referred to as staph aureus as it is commonly on the skin. The term MRSA refers to methicillin-resistant staph aureus. The methicillin resistance status is determined in the laboratory.
I would suggest that at some point, your mother will need to have the toe removed. The question of timing is an issue. It may be reasonable to talk with her physician to get a better handle on whether she will need surgical intervention. I would also anticipate she needs to be on antibiotics. Unfortunately, this is not a rare event.
JTL
