Emphysematous Spinous Osteomyelitis and Acute Pyelonephritis in Diabetic Patient.

Abstract

Spontaneous emphysematous osteomyelitis with concurrent pyelonephritis is exceedingly rare and fatal entity that needs prompt diagnosis. Imaging play a crucial role in its diagnosis. We present a case of 52 years old woman known case of diabetes and hypertension presenting to ER with high grade fever and right flank pain. CT scan abdomen and pelvis revealed intraosseous gas extending in epidural space and in retro peritoneum, suggesting emphysematous osteomyelitis, which was later confirmed by E coli in blood culture. Right kidney was also swollen and enlarged with surrounding perinephric stranding. Our case also highlights the importance of radiological imaging in Emergency settings particularly in patients with comorbid. Being familiar with this rare entity thus can help in early diagnosis and initiation of treatment.