According to Master of Science, Doctor Bach Nguyen Tra My from the General Internal Medicine Department, Tam Anh Hanoi General Hospital, Ms. Ngoc presented with significant swelling on her right face, which was hot, red, and taut. The inflammation had spread from her external ear canal to her earlobe, cheek, and eyelid. She experienced intermittent fever and significant fatigue. Lab tests confirmed a serious infection, elevated blood sugar, and kidney complications. Doctors diagnosed her with facial cellulitis, a direct result of uncontrolled diabetes.

Cellulitis is an acute infection of the skin and subcutaneous tissue, often caused by bacteria entering through minor injuries like abrasions, skin cracks, or unnoticed scratches. Facial cellulitis poses a risk due to the area's extensive network of blood vessels connected to the brain. Without prompt treatment, bacteria can enter the bloodstream, leading to sepsis and multi-organ failure.

Doctor Tra My explained that high blood sugar weakens the immune system, creating a favorable environment for bacterial growth. The ear and facial skin naturally host many resident bacteria, with staphylococcus aureus being a common cause of cellulitis. Scratching the ear with a hard or unhygienic object can abrade the ear canal skin, allowing bacteria to enter.

Ms. Ngoc was treated with intravenous antibiotics, blood sugar control, and kidney function monitoring. After 9 days of treatment, her health stabilized, and she was discharged, continuing her diabetes management.

Doctor Tra My examining Ms. Ngoc before discharge. *Photo: Tam Anh General Hospital*

Diabetics should not ignore signs of skin infections such as swelling, heat, redness, pain, and fever. Strict blood sugar control and adherence to long-term treatment are crucial; patients must not stop medication arbitrarily. It is important to care for and protect the skin, avoiding squeezing pimples or cutting hangnails, as these can easily cause skin abrasions. Even minor scratches require thorough cleaning and close monitoring, and medical consultation should be sought to prevent complications.

Thanh Ba