A 56-Year-Old Male Is Obese and Has Poorly Controlled Type

A 56-year-old male is obese and has poorly controlled type 2 diabetes mellitus. The home care nurse who changes the dressing on his chronic foot ulcer three times weekly has noted that the client's bone is now visible in the wound bed. The client has a fever and has not complained of any notable increase in pain to his foot. Which of the following statements best captures what is likely occurring?

A) The client is possibly experiencing direct penetration osteomyelitis in which microorganisms have entered through his foot wound.
B) Infectious microorganisms in his blood supply have proliferated in the distal portions of his skeletal system.
C) Vascular insufficiency has contributed to infection in both soft tissue and now his bone.
D) His immunocompromised status associated with diabetes has allowed skin flora to penetrate his foot bone via the surface wound.