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The leg that hurts more than it looks

A 58-year-old with diabetes has twelve hours of severe calf pain, a fever, and a faint blotchy redness that looks too mild for the agony.

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A 58-year-old with poorly controlled diabetes presents with twelve hours of rapidly worsening, severe calf pain after a minor shin abrasion. He is febrile, tachycardic and confused. The overlying skin is only faintly red.