A 58-year-old man visited our hospital with complaints of high grade fever and tenderness of the genitalia. He had received no treatment despite the fact that glycosuria had been detected one year previously. The patient had no apparent history of genital trauma or infection. His swollen and painful scrotum developed into a well demarcated and gangrenous lesion. After admission, a great deal of pus drained from the lesion and debridement of scrotal skin was performed combined with insulin administration and the wound was closed. The patient's diabetes mellitus was well controlled and his general condition improved.
Single-fiber electromyography (SFEMG) of anterior tibial muscle was performed in 23 type 2 diabetic subjects to determine its usefulness in evaluating diabetic neuropathy (DN).Jitter (MCD) and fiber density (FD), which are believed to indicate axonal degeneration with reinnervation, were measured in all patients Both parameters were significantly higher in patients with DN than in those without DN MCD: 77.9 ± 17.2 μ s vs 57.0 ± 16.6 μ s (p<0.01), FD: 2.74 ± 1.06 vs 1.68 ± 0.31 (p<0.05). All patients with DN showed abnormal values (mean+2SD of the values of healthy subjects) for either of MCD or FD, whereas none of the patients who showed normal values for both parameters had neuropathy, On the other hand, 6 of 13 patients without DN showed an abnormality in one of the other parameter. These results suggest that SFEMG might be a sensitive method to detect DN and useful to electrophysiologically evaluate the pathological process of DN.