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It is that diabetes mellitus increases tendency to develop infections and thrombosis. Impairment of various mechanisms and agents of humoral and cellular immune systems can be expected. Disturbances of platelet function, coagulation factors, and vascular structure predispose diabetics to thrombotic events. The course of both infections and thrombotic events is often worse than in non-diabetic patients. Presently described is 94-year-old male patient with diabetes who had orbital cellulitis that became complicated with cavernous sinus thrombosis (CST). He was admitted to endocrinology clinic with diagnoses of orbital cellulitis, urinary tract infection, hyperosmolar nonketotic state, acute renal failure, and compensated metabolic acidosis secondary to uremia. Despite immediate antibiotherapy, hydration, and additional required treatment, patient did not respond and died as a result of CST. There must be awareness, especially for diabetic patients, that orbital infections may spread to nearby cavernous sinuses and cause potentially lethal septic CST. Early diagnosis and immediate treatment are essential. [ABSTRACT FROM AUTHOR]

Background: Described in the present study is an analysis of appropriateness of antibiotics use for patients in whom infectious agent was detected. Data from patients in orthopedics and traumatology departments of two different hospitals in the same district were evaluated according to rational antibiotic drug use and culture antibiogram results. Methods: Data of patients diagnosed with infection between January 1, 2014 and December 31, 2015 in orthopedics and traumatology departments of two different hospitals were analyzed. Patients diagnosed with malignancy or who were discharged from other departments were excluded. A standard form was created to collect demographic data, culture antibiogram results, details of infectious agent, source of culture material, posology of antibiotic used, duration and appropriateness of use, and length of hospital stay. Costs were estimated based on 2014 Ministry of Health price list, and mean price of antibiotics per patient was recorded. Descriptive analyses were also completed. Results: It was determined that appropriate antibiotics for detected infectious agent were not always selected. Though there were cheaper effective antibiotics that could have been used according to antibiogram results, more expensive antibiotics were often chosen, which results in higher costs. Conclusion: Multidisciplinary approach in patient care and use of evidence-based guidelines should be increased. Teams should be formed and led by infectious disease and pharmacology specialists. New strategies should be developed immediately in health economics and new pharmacoeconomic models should be initiated in orthopedics and traumatology departments. [ABSTRACT FROM AUTHOR]