Case Of Diabetic Muscle Infarction Research Articles

Abstract #1167595: Diabetic Muscle Infarction: An Uncommon Diabetic Complication with a Lack of Standardized Treatment

Diabetic muscle infarction (DMI) is a rare yet serious complication that has been strongly associated with uncontrolled diabetes. We present a rare case of diabetic muscle infarction in an African American man with end-stage renal disease (ESRD). We discuss the challenges involved with the diagnosis and treatment of this rare condition.

Diabetic Muscle Infarction

Diabetic muscle infarction is a rare complication of diabetes. We describe 2 cases of diabetic muscle infarction, each one of them with a particular form of clinical presentation: recurrence, bilateral engagement, and unilateral compromise. Both cases had history of poorly controlled diabetes mellitus and diabetic nephropathy. The diagnosis was based on clinical, imaging, and anatomopathological features. The treatment was with a close control of diabetes mellitus, analgesics, short-term immobilization, and physical therapy.

Diabetic muscle infarction with complications

Diabetic muscle infarction (DMI) is a rare complication of diabetes mellitus (DM) that is often misdiagnosed. We report a case of diabetic muscle infarction and discuss diagnostic testing and treatment modalities to avoid complications. Case Report: A 50-year-old male presented with spontaneous left thigh swelling for five days. He had several previous episodes in the contralateral side with recurrent admissions. His past medical history consisted of poorly controlled type 2 DM on insulin therapy, end stage renal diseases on hemodialysis and hypothyroidism. Physical examination revealed a tight, warm, erythematous and tender left thigh. Laboratory examination showed white blood cell count 1.23x10⁴/µL with neutrophilia; hemoglobin 10.7 g/L, hematocrit 32.3%, alkaline phosphatase 792 U/L, creatinine 5.94 mg/dL and glucose 455 mg/dL. Venous ultrasound of left lower extremity revealed deep vein thrombosis in the mid left femoral vein however, venogram was negative. Compartment syndrome was considered and fasciotomy with biopsy was performed. Subsequently the patient worsened which lead to multiple re-interventions. After reviewing medical records from both our hospital and from other facilities, a diagnosis of DMI was established. Muscle biopsy supported this, revealing active macrophage infiltration with areas of necrosis. Treatment is conservative with pain management, rest and proper glycemic control. Surgical intervention is not necessary as it increases morbidity. Conclusion: Although rare, DMI is a serious and potentially disabling complication of uncontrolled DM which continues to be under-diagnosed. Recognizing DMI more efficiently could prevent the patient from undergoing numerous, unnecessary diagnostic procedures, and medical or surgical interventions which in turn can result in more harm than good for the patient.

A Case of Diabetic Muscle Infarction in Association with Insulin Treatment

A Case of Diabetic Muscle Infarction in Association with Insulin Treatment

Diabetic Muscle Infarction: A Rare Complication of Long-Standing and Poorly Controlled Diabetes Mellitus

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.

A Case of Diabetic Muscle Infarction

A Case of Diabetic Muscle Infarction

Painful foot drop; a presentation of diabetic muscle infarction

Macro- and microvascular complications of diabetes are varied and can present with a range of clinical signs and symptoms. Diabetic muscle infarction is a rare vascular complication of diabetes that is often not recognized. We report a case of diabetic muscle infarction, where a 65-year-old woman with Type 2 diabetes presented with acute-onset severe pain in her right leg and foot drop. Her foot drop was a result of a concomitant compression nerve injury as a consequence of the muscle oedema following infarction. Our case highlights the importance of early recognition and investigation of atypical presentations of vascular complications of diabetes.

A Case of Diabetic Muscle Infarction

A Case of Diabetic Muscle Infarction

Two Cases of Diabetic Muscle Infarction

Two Cases of Diabetic Muscle Infarction

A Case of Diabetic Muscle Infarction Despite Good Diabetic Control

A Case of Diabetic Muscle Infarction Despite Good Diabetic Control

Diabetic Muscle Infarction of the Forearm in a Patient with Long-Standing Type 1 Diabetes

To describe a case of diabetic muscle infarction affecting an upper extremity in a patient with long-term poorly controlled diabetes. A case report of a patient with diabetes who presented with pain and swelling of his left arm is described, including clinical, laboratory, and radiologic findings. The results of pathologic examination are also illustrated. Moreover, we review the literature in a discussion of the evaluation, pathogenesis, and treatment of diabetic muscle infarction. A 41-year-old man with type 1 diabetes presented with a 1-week history of painful swelling of the left forearm. The leukocyte count and creatine kinase levels were normal. Magnetic resonance imaging of the left forearm revealed extensive deep tissue edema and an increase in T2 signal in the involved muscles. The patient was initially treated for cellulitis with intravenously administered antibiotics for 3 weeks without improvement. Muscle biopsy revealed skeletal muscle with prominent muscle fiber degeneration, myophagocytosis, and fibrosis, consistent with the diagnosis of diabetic muscle infarction. Once this diagnosis was made, antibiotic therapy was discontinued, and the condition was managed with narcotics and aggressive insulin therapy. Eight weeks after initial presentation, the patient reported complete resolution of symptoms. Diabetic muscle infarction is a rare but underrecognized complication of diabetes. To our knowledge, we present only the second such reported case of upper extremity involvement in the literature. The results of pathologic examination interpreted in the context of the patient's clinical history were consistent with the diagnosis.

Diabetic muscle infarction: an underdiagnosed complication of a common disease

Diabetic muscle infarction is a rare but under-reported complication of diabetes mellitus. The condition characteristically affects poorly-controlled type 1 diabetic patients with severe microvascular complications. In most of the reported cases, patients have not presented until several weeks into the illness and serum creatine kinase levels were not elevated. We describe a case of diabetic muscle infarction occurring in a type 2 diabetic patient with no evidence of significant retinopathy, neuropathy or nephropathy. Due to the acute presentation of our patient, we are able to demonstrate a large rise in serum creatine kinase levels not previously seen. Copyright © 2005 John Wiley & Sons, Ltd.

A Case of Diabetic Muscle Infarction: A Rare Complication of Diabetes Mellitus

A Case of Diabetic Muscle Infarction: A Rare Complication of Diabetes Mellitus

Multiple Recurrences of Diabetic Muscle Infarction

This is the report a case of diabetic muscle infarction (DMI) associated with multiple recurrences and a review of the literature on DMI from the first description in 1965 to the present. Specifically the review of the clinical, laboratory, and muscle histopathologic features of 86 reported cases of DMI.Patients with DMI usually present with acute or subacute focal lower extremity muscle pain or swelling. Elevations in the white blood cell count and erythrocyte sedimentation rate are common laboratory findings. Magnetic resonance imaging, a highly sensitive diagnostic test in DMI, shows increased T2-weighted signal and edema in affected muscles. Typical muscle histopathology includes muscle fiber necrosis and endomysial inflammation. Slow symptomatic improvement usually occurs over a period of 1 to 6 months. Conservative therapy and analgesics seem appropriate for most patients. Although self-limiting, DMI is often associated with recurrent muscle infarctions and multisystem diabetes-related complications. Diabetes-induced arteriosclerosis and microangiopathy are the suggested causes of DMI.It is concluded that DMI is an uncommon but probably underrecognized disorder causing focal muscle pain and swelling, usually of thigh or calf muscles, in patients with diabetes mellitus complicated by poorly controlled hyperglycemia and multiorgan complications.

Diabetic muscle infarction: an underdiagnosed complication of long-standing diabetes.

To systematically review all the reported cases of diabetic muscle infarction (DMI) and its pathogenesis, clinical features, prognostic implications, and management. We searched databases (MEDLINE and EMBASE) from their inception to August 2001 and reviewed bibliographies in reports retrieved. Data were extracted in a standardized form. A total of 47 references were retrieved; 115 patients and 166 episodes were included. DMI was more frequent in women (61.5%, mean age at presentation 42.6 years). Of the cases, 59% had type 1 diabetes; the mean duration of disease was 14.3 years, and multiple diabetic end-organ complications were noted. DMI affects the lower limbs with abrupt onset of pain and local swelling. Diagnosis is made by biopsy, but the characteristic features in magnetic resonance imaging are very typical. Treatment includes bed rest and administration of analgesics, but recurrence is common. DMI is a very uncommon complication of long-standing diabetes; presentation is well characterized and management is simple.

A case of diabetic muscle infarction

AbstractSpontaneous muscle infarction is a rare complication of long‐standing diabetes, which most commonly involves the thigh. We report a 27‐year old patient with type 1 diabetes who experienced infarction of the anterior compartment of the leg, which resulted in potential nerve injury and a permanent foot drop.

A case of diabetic muscle infarction in Japan

A case of diabetic muscle infarction in Japan