Acute exacerbation of chronic osteomyelitis triggered by agg
Published in the Journal of Medical Case Reports, the authors report a case of chronic osteomyelitis under poorly controlled diabetic conditions.

A 58-year-old man had acute exacerbation of chronic osteomyelitis triggered by aggravation of type 2 diabetes mellitus. He had acute osteomyelitis in his right lower leg in his babyhood. After this episode, he did not experience any pain in his leg for approximately 50 years; he felt acute pain in his right lower leg at the age of 50 when his glycemic control was very poor.

He then started undergoing medical therapy for type 2 diabetes mellitus and, after an improvement in glycemic control, his pain was gradually mitigated. However, he did not take medicine for approximately 8 months at the age of 58.

After the interruption, glycemic control became very poor and he felt the similar acute pain again in the same area. After improving glycemic control, his pain was gradually mitigated again as observed at the age of 50.

Learning points:-
- We should bear in mind that T2DM is one of the major risk factors for osteomyelitis and that chronic osteomyelitis could be triggered by a disturbance in the glycemic control of patients with T2DM.

- In addition, when a patient has a past history of acute osteomyelitis, we should pay attention to the possible risk of acute exacerbation of chronic osteomyelitis especially under immunotolerance status, such as poorly controlled T2DM.

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