Emphysematous Osteomyelitis: Literature Review and a Case Report

Abstract

Emphysematous osteomyelitis is a rare form of osteomyelitis characterized by the presence of intraosseous gas. It is caused by gas-forming organisms, most commonly being members of the Enterobacteriaceae family (particularly Escherichia coli) or anaerobes. Comorbidities such as diabetes mellitus, malignancy, alcohol abuse, Crohn’s disease, and other etiologies causing immune suppression, predispose to this condition. A prompt diagnosis of this potentially fatal condition is required to expedite early management. We present a patient diagnosed with multifocal emphysematous osteomyelitis involving the pelvic bones, left proximal femur, vertebral bodies, ribs, and clavicle caused by E. coli to highlight the unusual diffuse involvement by this rare disease. In addition, we reviewed 58 reported cases of emphysematous osteomyelitis including our case. Our purpose in revising all these cases was to observe any significant difference in outcome (if any exists in mortality) based on age, gender, causative organism, site of involvement, and treatment received. However, we could not observe any significant difference in outcome.