Abstract
A 52-year-old man was admitted to our hospital due to a right foot ulcer and fever. Four years prior, he underwent amputation of a toe on the same foot due to a diabetic foot condition. Because insulin therapy had been interrupted for 3 years, his serum glycosylated hemoglobin level was 11.7 %. A diagnosis of an infected diabetic foot ulcer (DFU) was made. Culture studies from both the foot ulcer and the blood revealed the presence of methicillin-sensitive Staphylococcus aureus (MSSA) and Streptococcus dysgalactiae, a group G streptococcus. Transesophageal echocardiography identified a verruca on the aortic valve, confirming infective endocarditis (IE). Successful treatment was achieved through standard intra-venous ceftriaxone therapy for IE following confirmation via antibiotic sensitivity testing .Hyperglycemia increases the risk of musculoskeletal infection and IE, where DFU can serve as a portal of systemic infection. Although group G streptococcal infections have been growing due to super-aging and multi-morbidity, IE with group G streptococci may remain undiagnosed. Early closure of DFU wounds, effective blood-glucose control, and appropriate microbiological and imaging studies are essential for preventing and treating systemic infections related DFU.
