Emphysematous osteomyelitis

Last revised by Pradosh Kumar Sarangi on 03 Jul 2021

Emphysematous osteomyelitis is an extremely rare form of osteomyelitis which is complicated by infection with gas-forming organisms. Only a handful of cases are published in the literature.

Commonly reported organisms include 1

  • Fusobacterium necrophorum  
  • Escherichia coli 4
  • Bacteroides spp.
  • Klebsiella pneumoniae

The vertebrae may be involved in ~40% of cases 1

It is characterized by the presence of intraosseous gas (pumice stone sign) accompanied by other signs of bony and soft tissue infection.

It was initially described by P C Ram and colleagues in 1981 2.

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Cases and figures

  • Case 1
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