Susceptibility to infections in persons with diabetes mellitus
- Amy C Weintrob, MD
Amy C Weintrob, MD
- Associate Professor of Medicine
- The George Washington University and Veterans Affairs Medical Center
- Daniel J Sexton, MD
Daniel J Sexton, MD
- Editor-in-Chief — Infectious Diseases
- Section Editor — Bacterial Infections
- Professor of Medicine
- Duke University Medical Center
It is widely accepted by both the medical profession and the general public that diabetics have an increased propensity to develop infections. Despite a number of both systemic and local host factors that can contribute to infections, whether diabetics truly are at greater risk for infection and the magnitude of the effect of diabetes on the risk of infection remain active questions. In addition, the types of infections observed in patients with diabetes mellitus (DM) are also complex.
Host- and organism-specific factors that may explain why people with DM are more susceptible to particular infections will be reviewed here. The clinical features, diagnosis, and treatment of specific infections that appear either to be more prevalent in diabetics or to have unique features when they occur in diabetics are discussed separately. These infections include:
●Urinary tract infections, including fungal infections (see "Emphysematous urinary tract infections")
●Superficial fungal infections, such as oral candidiasis, onychomycosis, and intertrigo (see "Clinical manifestations of oropharyngeal and esophageal candidiasis" and "Onychomycosis: Epidemiology, clinical features, and diagnosis" and "Candidal intertrigo")
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- ARE DIABETICS MORE SUSCEPTIBLE TO INFECTION?
- HOST FACTORS
- Hyperglycemia-related impairment of immune response
- Vascular insufficiency
- Sensory peripheral neuropathy
- Autonomic neuropathy
- Increased skin and mucosal colonization
- ORGANISM-SPECIFIC FACTORS
- Candida albicans
- Rhizopus species
- Burkholderia pseudomallei
- Uropathogenic Escherichia coli
- INFORMATION FOR PATIENTS