Concurrent Presentation of Emphysematous Pyelonephritis, Emphysematous Osteomyelitis, and Psoas Abscesses

Abstract

Emphysematous pyelonephritis (EPN) is an uncommon necrotizing infection commonly seen in people with diabetes. Emphysematous osteomyelitis (EOM) is a rare form of pyogenic osteomyelitis characterized by the presence of air in the bones. A combination of both these infections has been reported only thrice in the literature. We present the case of a middle-aged diabetic woman who had both these rare infections along with psoas abscesses, a phenomenon that has been described only once previously. The patient required prolonged hospitalization, surgical debridement and drainage, a double-J stent, and meropenem, and she subsequently achieved full recovery.

Emphysematous Osteomyelitis of the Lumbar Spine and Sacrum After Liver Transplantation: A Case Report

“…CT imaging shows clusters of multiple, irregular intraosseous gas pockets < 1 cm in size, referred to as the pumice stone sign [ 5 ]. In this case, vertebral compression fractures were seen, a complication reported in several studies of EO [ 6 , 10 , 11 ]. The infection weakens the bone, leading to fragility and subsequent compression fractures.…”

A Rare Facultative Anaerobe Causing Emphysematous Osteomyelitis of the Pubic Bone

“…Emphysematous osteomyelitis is a rare condition considered a subtype of pyogenic osteomyelitis [5]. It is caused by gas-forming bacteria in most instances and is characterized by locules of air within the bone.…”

Emphysematous osteomyelitis of the spine with emphysematous pyelonephritis: A rare coexistence

“…Emphysematous pyelonephritis is seen mostly in diabetic individuals and is characterized by the presence of gas in the renal parenchyma, collecting system, or perinephric tissue. [ 4 5 ] The latter is a relatively more frequently reported condition, but only 46 cases of the former have been reported in the literature as of July 2020. [ 5 ] As per our knowledge, the simultaneous presence of emphysematous pyelonephritis and emphysematous osteomyelitis in a patient has only been reported five times in the past,[ 5 ] and here, we presented a similar case of this exceedingly rare coexistence.…”