Khan Adil, Zaidi Farah N, Anwar Maryem, Ahmad Mashhood, Rehman Anees Ur
Internal Medicine, Khyber Medical College, Peshawar, PAK.
Medicine, Queen Elizabeth Hospital, King's Lynn, GBR.
Cureus. 2023 Jun 30;15(6):e41208. doi: 10.7759/cureus.41208. eCollection 2023 Jun.
Gas-forming bacteria like (SA), along with the worrisome infections it causes, can lead to a fairly overlooked but lethal complication, called emphysematous osteomyelitis (EO). It is a condition characterized by the infection of bones complicated by the presence of gas-forming organisms. Here, we present a 50-year-old woman with insulin-dependent type 2 diabetes, who presented with cough, high-grade fevers, rigors, chills, and back pain from the last seven days. Laboratory tests revealed elevated inflammatory markers and a hyperosmolar hyperglycemic state. Sputum smear and blood cultures both reported the presence of SA. The presence of air foci in the third lumbar spine vertebra (L3) and the surrounding soft tissue was confirmed by computed tomography (CT). The posterior elements were spared, and the vertebral height and intervertebral disc were preserved. The extent of the damage done to the bone was analyzed by magnetic resonance imaging (MRI). The findings showed transverse relaxation time (T2) and short tau inversion recovery (STIR) sequences, consistent with the diagnosis of EO. She was put on strict glucose monitoring and a combination of intravenous antibiotics for three weeks followed by two weeks of oral therapy. Her symptoms improved with conservative management and reported no recurrence of any symptom of such type ever since.
像金黄色葡萄球菌（SA）这样的产气细菌，连同它所引发的令人担忧的感染，可能导致一种相当被忽视但却致命的并发症，称为气性骨髓炎（EO）。它是一种以骨骼感染并伴有产气微生物为特征的病症。在此，我们介绍一位50岁的2型胰岛素依赖型糖尿病女性患者，她在过去七天出现咳嗽、高热、寒战、发冷和背痛。实验室检查显示炎症标志物升高以及高渗高血糖状态。痰涂片和血培养均报告有金黄色葡萄球菌存在。通过计算机断层扫描（CT）证实第三腰椎（L3）椎体及其周围软组织存在气灶。后部结构未受影响，椎体高度和椎间盘得以保留。通过磁共振成像（MRI）分析骨骼受损程度。结果显示横向弛豫时间（T2）和短tau反转恢复（STIR）序列，符合气性骨髓炎的诊断。她接受了严格的血糖监测，并联合静脉注射抗生素治疗三周，随后口服治疗两周。经过保守治疗，她的症状有所改善，且自那以后再也没有出现过此类症状的复发。
