High-acuity infections to remember in patients with diabetes:
- Rhino-orbital-cerebral mucormycosis—especially with DKA; facial or sinus pain, eye swelling, vision changes, or cranial nerve findings are alarming.
- Necrotizing soft-tissue infection, including Fournier gangrene and infected wet gangrene of the foot.
- Severe diabetic foot infection—deep abscess, necrotizing infection, osteomyelitis, or infection with limb ischemia.
- Emphysematous infections: cholecystitis, pyelonephritis, or cystitis; gas in the organ wall or tissue can signal a rapidly progressive infection.
- Malignant (necrotizing) otitis externa with possible skull-base osteomyelitis—consider with severe, persistent ear pain or drainage.
- Renal or perinephric abscess and obstructive pyelonephritis/urosepsis.
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