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

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.