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Diabetic muscle infarction: a rare complication of long-standing and poorly controlled diabetes mellitus.
[pyomyositis]
Objective
.
To
report
a
case
of
diabetic
muscle
infarction
(
DMI
)
,
a
rare
complication
of
long
-standing
poorly
controlled
diabetes
mellitus
.
Methods
.
We
describe
a
case
of
a
45
-
year
-old
male
with
an
approximately
8
-
year
history
of
poorly
controlled
type
2
diabetes
mellitus
with
multiple
microvascular
complications
who
presented
with
the
sudden
onset
of
left
thigh
pain
and
swelling
.
He
had
a
swollen
left
thigh
and
a
CK
of
1670
 
U
/
L
.
He
was
initially
treated
with
intravenous
antibiotics
for
a
presumptive
diagnosis
of
pyomyositis
or
necrotizing
fasciitis
with
no
improvement
.
A
diagnosis
of
diabetic
muscle
infarction
was
considered
.
Results
.
An
MRI
of
the
thigh
demonstrated
diffuse
edema
in
the
anterior
compartment
.
A
muscle
biopsy
demonstrated
coagulation
necrosis
in
skeletal
muscle
and
inflammation
and
infarction
in
the
walls
of
small
blood
vessels
.
These
studies
confirmed
the
final
diagnosis
of
DMI
.
He
was
treated
with
supportive
care
and
gradually
improved
.
Conclusion
.
DMI
is
a
rare
complication
of
diabetes
that
is
often
mistaken
for
infections
such
as
pyomyositis
and
necrotizing
fasciitis
or
thrombophlebitis
.
Treatment
is
supportive
.
Although
the
short
-term
prognosis
is
good
in
these
patients
,
the
long
-term
prognosis
is
poor
.
Diseases
Validation
Diseases presenting
"fasciitis with no improvement"
symptom
pyomyositis
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