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    A Case of Type 2 Diabetes Complicated With Primary Pyomyositis
    (Lippincott Williams & Wilkins, 2009) Ukinc, Kubilay; Bayraktar, Miyase; Uzun, Oemruem
    Primary pyomyositis is a deep bacterial pyogenic infection of the skeletal muscles that can cause abscess formation. Due to the indefinite nature of the symptoms and signs of pyomyositis, the diagnosis is difficult to make. A 57-year-old male patient with a 10-year history of type 2 diabetes mellitus was seen with a complaint of right calf pain, swelling, and stiffness that was present for 2 months. Temperature was 38.2 degrees C. Hommans sign was positive and peripheral pulses were palpable. Laboratory values showed a white blood cell count of 18300/mu L, an erythrocyte sedimentation rate of 85 mm/h, and a CRY of 18.3 mg/dL. MRI showed a 26 X 8-cm abscess and an 8 X 5.5-cm focus of pyomyositis inside the gastrocnemius muscle. Parenteral amikacin+sulbactam-ampicillin was begun. Culture revealed Staphylococcus aureus.
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    Hypothyroid Graves' disease complicated with elephantiasis nostras verrucosa (ENV): a case report and review of the literature
    (Springer, 2009) Ukinc, Kubilay; Bayraktar, Miyase; Gedik, Arzu
    Thyroid dermopathy is not a frequent feature of hyperthyroid Graves' disease, being present in less than 5% of the patients. Graves' disease has been shown to exist in euthyroid or hypothyroid forms in untreated patients. Here, we describe a case of hypothyroid Graves' disease with elephantiasis nostras verrucosa (ENV), which is an extreme form of thyroid dermopathy (TD). A 58-year-old female patient was admitted to the emergency department with somnolence, hypothermia, and bradycardia. Her mental status gradually worsened, resulting in a deep coma. She was intubated and followed in the intensive care unit, as she needed mechanical ventilatory assistance due to respiratory failure. She also had bilateral non-pitting edema, a cobblestone-like appearance, and hyperkeratotic greenish-brown-colored lesions in the pretibial and dorsal regions of the feet that were compatible with ENV. Hypothyroid Graves' disease is a very rare condition among autoimmune thyroid disorders, and ENV is an extremely rare form of TD. Here, we present a patient with hypothyroid Graves' disease and ENV.