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February 21, 1942


Author Affiliations

U. S. Veterans' Administration Facility, Columbia, S. C.

JAMA. 1942;118(8):664. doi:10.1001/jama.1942.02830080096026

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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

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