Serious infections in elderly patients with diabetes mellitus.

The elevated serum glucose levels associated with diabetes mellitus (DM) alter host immune responses, resulting in a well-documented increase in the predisposition to infectious processes. Furthermore, the cumulative effect of age-related immune senescence, superimposed on this enhanced risk of infections, can lead to serious and life-threatening infections in elderly patients with DM. Because infection associated with aging can frequently present in a subtle and atypical manner, prompt recognition of infection and treatment with appropriate empirical broad-spectrum antimicrobial agents, in conjunction with surgical intervention, is often necessary to eradicate such infections. Common sites of serious infection associated with DM include the head and neck, biliary tract, and urinary tract, as well as the skin, soft tissue, and bony structures of the feet in particular.