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To the Editor:—
In The Journal, Dec. 27, 1941 Carl L. Gillies reported 4 cases of interstitial emphysema in diabetes caused by the colon bacillus. It seems worth while at this time to call attention to the fact that Proteus vulgaris may also be a producer of gas in cases of diabetes.In August 1939, in Joseph Tenopyr's service at Kings County Hospital, Brooklyn, I attended a young diabetic Negress who had a painful, large, hard, cracked callosity on the heel. While she was in the hospital an area of cellulitis adjacent to the callus appeared, associated with a decided elevation of the pulse rate and of the temperature. A dirty brownish serous discharge with a "musty" odor oozed from the crack, and a few days later an area of crepitation in the tissues surrounding the heel was noted, which soon spread to involve similarly the entire lower extremity. Roentgen
Leder HL. PROTEUS VULGARIS AS GAS PRODUCER IN DIABETES. JAMA. 1942;118(8):664. doi:10.1001/jama.1942.02830080096026