Version July 2025
| Findings suggesting a more serious diabetes‐related foot infection | |
| Wound specific | |
| Wound | Penetrates to subcutaneous tissues (eg, fascia, tendon, muscle, joint, or bone) |
| Cellulitis | Extensive (>2 cm), distant from ulceration, or rapidly progressive (including lymphangitis) |
| Local signs/symptoms | Severe inflammation or induration, crepitus, bullae, discolouration, necrosis or gangrene, ecchymoses or petechiae, and new anaesthesia or localised pain |
| General | |
| Presentation | Acute onset/worsening or rapidly progressive |
| Systemic | Fever, chills, hypotension, confusion, and volume depletion |
| Laboratory tests | Leucocytosis highly elevated C‐reactive protein, or erythrocyte sedimentation rate, severe or worsening hyperglycemia, acidosis, new/worsening azotaemia and electrolyte abnormalities tests |
| Complicating features | Presence of a foreign body (accidently or surgically implanted), puncture wound, deep abscess, arterial or venous insufficiency, lymphoedema, immunosuppressive illness or treatment, acute kidney injury |
| Failing treatment | Progression while on apparently appropriate antibiotic and supportive therapy |
