2015 Volume 58 Issue 2 Pages 115-120
The present case involved a 62-year-old woman diagnosed with type 2 diabetes in 2001 who exhibited poor glycemic control due to self-discontinuation of treatment. After sustaining a bruise on the left buttock in December 2010, she suffered low back pain, which worsened over time. In April 2011, she was admitted to our hospital in poor general condition with deficient glycemic control (blood glucose, 426 mg/dl; HbA1c, 11.9 %). Computed tomography showed a large gas-forming abscess extending from the left paravertebral muscle at the L1 level to the internal and external muscles of the pelvis, accompanied by bone destruction in the left sacroiliac joint and right pubis. Insulin was used to reduce the marked hyperglycemia, and the deep abscess was drained by incising the skin immediately above the left sacroiliac joint. Continuous closed irrigation was performed for two weeks under aggressive intravenous antimicrobial therapy; this combination therapy resulted in an improvement in the patient's general condition. This case illustrates the possibility of diabetic neuropathy presenting as hypoalgesia of trunk deep tissues and stresses the need for a thorough examination in diabetic patients with poor glycemic control who report low back pain, irrespective of the severity of the pain.
