Pyogenic clavicular osteomyelitis associated with disseminated intravascular coagulation and acute renal failure in a patient with non-insulin-dependent diabetes mellitus

Intern Med. 1997 Nov;36(11):810-4. doi: 10.2169/internalmedicine.36.810.

Abstract

Pyogenic osteomyelitis is often accompanied by diabetes, but the disease in the clavicula has rarely been reported. We describe an unusual case of a 53-year-old man with poorly controlled non-insulin-dependent diabetes mellitus who presented with pyogenic clavicular osteomyelitis and developed DIC and acute renal failure. A 67Ga scintigram revealed an abnormal accumulation of the isotope in the right clavicula, where magnetic resonance imaging (MRI) showed inflammatory changes. This suggests that a 67Ga scintigram and MRI are of clinical value for the early diagnosis of the disease. Antibiotic chemotherapy with gamma-globulin and gebexate mesilate, and hemodialysis almost cured his serious condition.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / complications*
  • Acute Kidney Injury / therapy
  • Anti-Bacterial Agents
  • Anticoagulants / therapeutic use
  • Clavicle* / diagnostic imaging
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Disseminated Intravascular Coagulation / complications*
  • Disseminated Intravascular Coagulation / drug therapy
  • Drug Therapy, Combination / therapeutic use
  • Follow-Up Studies
  • Gabexate / therapeutic use
  • Gallium Radioisotopes
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Immunization, Passive / methods
  • Insulin / therapeutic use
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Osteomyelitis / complications*
  • Osteomyelitis / diagnosis
  • Osteomyelitis / therapy
  • Radionuclide Imaging
  • Renal Dialysis
  • gamma-Globulins / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Anticoagulants
  • Gallium Radioisotopes
  • Hypoglycemic Agents
  • Insulin
  • gamma-Globulins
  • Gabexate