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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
"muscle biopsy"
symptom
cadasil
canavan disease
cohen syndrome
epidermolysis bullosa simplex
familial mediterranean fever
focal myositis
inclusion body myositis
neuralgic amyotrophy
pyomyositis
pyruvate dehydrogenase deficiency
sneddon syndrome
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