Clinical classification of a diabetic foot infection

Infection severity	Clinical manifestations of infection
Uninfected	Wound lacking purulence or any manifestations of inflammation.
Mild	Presence of ≥2 manifestations of inflammation (purulence, or erythema, pain, tenderness, warmth, or induration), but any cellulitis/erythema extends ≤2 cm around the ulcer, and infection is limited to the skin or superficial subcutaneous tissues; no other local complications or systemic illness.
Moderate	Infection (as above) in a patient who is systemically well and metabolically stable but which has ≥1 of the following characteristics: cellulitis extending >2 cm, lymphangitic streaking, spread beneath the superficial fascia, deep-tissue abscess, gangrene, and involvement of muscle, tendon, joint or bone.
Severe	Infection in a patient with systemic toxicity or metabolic instability (eg, fever, chills, tachycardia, hypotension, confusion, vomiting, leukocytosis, acidosis, severe hyperglycemia, or azotemia).

Clin_classif_DM_foot_infx.htm

Foot ischemia may increase the severity of any infection, and the presence of critical ischemia often makes the infection severe.

Reproduced with permission from: Lipsky, BA, Berendt, AR, Deery, HG, et al. Diagnosis and Treatment of Diabetic Foot Infections. Clin Infect Dis 2004; 39:885. Copyright ©2004 The University of Chicago Press.

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Clinical classification of a diabetic foot infection