# Synchronous Multifocal Necrotizing Soft Tissue Infection of the Upper and Lower Limbs in a Patient With Diabetic Ketoacidosis: A Report of a Rare Case

## TL;DR

A rare case of simultaneous soft tissue infections in a diabetic patient's upper and lower limbs is reported, highlighting unusual spread patterns.

## Contribution

Presents a rare case of synchronous multifocal necrotizing soft tissue infection in diabetic ketoacidosis.

## Key findings

- Patient presented with generalized pain and septic shock despite minimal skin symptoms.
- Whole-body imaging identified extensive fascial plane abscesses in upper and lower limbs.
- Recovery followed three surgical debridements and prolonged antibiotic treatment.

## Abstract

A 67-year-old man with no history of diabetes presented with generalized body pain and impaired mobility. He was admitted with severe hyperglycemia, diabetic ketoacidosis, and septic shock. Although the patient experienced minimal cutaneous symptoms, he experienced progressive swelling and pain in the right upper and left lower extremities. Whole-body imaging revealed an extensive fascial plane abscess. He underwent three surgical debridements and improved with prolonged antibiotic therapy. Necrotizing soft tissue infections are rapidly progressing and life-threatening. This case highlights a rare form of hematogenous spread that causes simultaneous multifocal soft-tissue infections rather than extending from a single localized source.