A 55-year-old man with type 2 diabetes presents complaining of a “foot infection.” He is noted to have foul-smelling and purulent drainage from a 10-cm left plantar ulcer with bone exposure. His temperature is 39.4°C (102.9°F) and blood pressure is 90/60 mm Hg.

The serum WBC is 35,000 cells/m3, and x-ray findings indicate extensive osteomyelitis involving several metatarsal bones and gas within the soft tissue in the lower leg. Source: Case Files Surgery