Work

Emphysematous osteomyelitis complicated with liver abscess and pulmonary infection in a diabetic patient: a case report

Year: 2025

Type: article

Abstract: Emphysematous osteomyelitis (EO) is a life-threatening bone infection. In this case, we present a 67-year-old male patient with congenital deaf-mutism, hypertension, and diabetes mellitus. He was admitted to the emergency department due to “altered mental status for 2 h”, and blood tests revealed a significant elevation of infectious markers. Computed tomography (CT) scans showed multiple gas-density shadows in the L3 vertebral body, along with pneumocele in the spinal canal at the same level, the right psoas major muscle, and the diaphragm. Abdominal CT examination indicated a liver abscess in the right lobe of the patient’s liver. Pulmonary CT suggested multiple infectious lesions in the lungs. Subsequent cultures of blood, liver abscess drainage fluid, and cerebrospinal fluid all confirmed an infection with Klebsiella pneumoniae. The final diagnosis was “emphysematous osteomyelitis”, and the patient received anti-infective treatment and other supportive therapies, leading to the remission of his condition. Diabetes and malignant tumors are recognized as major risk factors for emphysematous osteomyelitis, while iatrogenic intervention may be a potential predisposing factor in the pathogenesis of the disease. Our report emphasizes the key role of identifying EO through unique imaging features (such as the “pumice stone” sign).

Source: Clinical Infection in Practice

DOI: 10.1016/j.clinpr.2025.100526

Authors: Zidan Yang, Jingxin Zhang, Fan Yang

Institution: Renmin Hospital of Wuhan University

Language: English

Topic: Orthopedic Infections and Treatments

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,000