足潰瘍が起因となり腸腰筋膿瘍を発症したと考えられた2型糖尿病の一剖検例

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  • ソクカイヨウ ガ キイン ト ナリ チョウヨウキン ノウヨウ オ ハッショウシタ ト カンガエラレタ 2ガタ トウニョウビョウ ノ イチ ボウケンレイ
  • An Autopsy Case of Type 2 Diabetes Complicated by an Abscess in the Psoas Muscle Due to a Foot Ulcer

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A 63-year-old man with a 20-year history of type 2 diabetes had been receiving treatment for an ulcer on the right sole of his foot since 2003. Thereafter, Methicillin-resistant staphylococcus aureus (MRSA) was identified in his foot ulcer in June 2005. On July 14, 2005, he was admitted to our hospital due to a high-grade fever, and his laboratory findings (WBC 14,400/μl, CRP 23.43 mg/dl) showed a severe inflammation. Bacteriological examinations of his blood confirmed the MRSA sepsis. He was found to have an abscess in the bilateral psoas muscle on abdominal computed tomography. His condition thereafter worsened and he eventually died due to septic shock. We confirmed the abscess in the bilateral psoas muscle during an autopsy and a bacteriological examination of his abscess confirmed the presence of MRSA. We considered the mechanism of action in this case to have been the abscess in the psoas muscle due to an MRSA infection in the patient's right foot ulcer, thus eventually leading to septic shock and death.

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