Emphysematous Osteomyelitis: Three Rare Cases

Emphysematous osteomyelitis is a rare condition caused by gas-producing bacteria in the bone and may be visualized by the presence of intraosseous gas on imaging. We report three cases of emphysematous osteomyelitis. The first case is an 80-year-old with acute myeloid leukemia with emphysematous osteomyelitis of the sacrum, right iliac bone, and multiple vertebrae and ribs. Blood cultures grew <i>Enterococcus faecium</i> and <i>Clostridium</i> spp. The second case is a 45-year-old man with diabetes mellitus with emphysematous osteomyelitis of the proximal left tibia with blood cultures positive for <i>Proteus mirabilis</i> and <i>Clostridium perfringens</i>. The final case is a 57-year-old male with diabetes mellitus who presents with emphysematous osteomyelitis of the left fifth metatarsal head. Wound cultures were positive for <i>Klebsiella pneumoniae</i> and <i>Proteus mirabilis</i>. Emphysematous osteomyelitis is associated with significant morbidity and mortality, and so an accurate and quick diagnosis is important for the radiologist to make.