Emphysematous osteomyelitis of lumbar spine: a rare case report and review of literature

Rationale: There are very few cases of emphysematous osteomyelitis documented in the literature, and it is one of the rare diseases brought on by gas-forming bacteria. Patient concerns: A 63-year-old male was admitted to the orthopaedics ward with the chief complaints of fever and low back pain for one week and shortness of breath for three days. He was a known case of old pulmonary tuberculosis with chronic obstructive pulmonary disease (COPD) and pulmonary artery hypertension (PAH). Diagnoses and interventions: On CT scan, multiple air pockets were noted in L4 & L5 vertebrae. After a CT scan, a probable diagnosis of emphysematous osteomyelitis was made and empirically, antibiotics were started. Fine needle aspiration under CT-guided cytology was done, and Klebsiella pneumoniae was identified based on culture and sensitivity. After confirmation, specific antibiotics were started, and he improved gradually. The patient had a significant improvement in back pain after the treatment.