Revisiting Diabetic Myonecrosis: A Case Report Highlighting Diagnostic and Management Challenges

A 41-year-old man with a history of uncontrolled type 2 diabetes mellitus presented with acute thigh pain and fever. He had tense muscle compartments, skin discoloration, and erythema with elevated inflammatory markers on blood labs. Ultrasonography revealed grossly edematous muscles, and culture showed growth of streptococcal dygalactae. Biopsy revealed histiocytic infiltrates with interstitial edema of muscle fibers. The patient was treated with surgical exploration, fluids, and broad-spectrum antibiotics, which led to complete recovery. This case highlights the potential development of diabetic myonecrosis owing to suboptimal blood glucose control. As well it demonstrates the pathophysiology, presentations, and management approach of the disease.