Pyogenic clavicular osteomyelitis associated with disseminated intravascular coagulation and acute renal failure in a patient with non-insulin-dependent diabetes mellitus.
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.
Yoshioka
K
K
First Department of Internal Medicine, Matsushita Memorial Hospital, Moriguchi, Osaka.
Nagata
H
H
Nakamura
Y
Y
Kasamatsu
Y
Y
Yokoo
S
S
Yoshida
T
T
Kondo
M
M
D058186:Acute Kidney Injury / Q000150:complications* / Q000628:therapy; D000900:Anti-Bacterial Agents; D000925:Anticoagulants / Q000627:therapeutic use; D002968:Clavicle / Q000000981:diagnostic imaging; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy; D004211:Disseminated Intravascular Coagulation / Q000150:complications* / Q000188:drug therapy; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005500:Follow-Up Studies; D016670:Gabexate / Q000627:therapeutic use; D005710:Gallium Radioisotopes; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007116:Immunization, Passive / Q000379:methods; D007328:Insulin / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D011877:Radionuclide Imaging; D006435:Renal Dialysis; D005719:gamma-Globulins / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000925:Anticoagulants; D005710:Gallium Radioisotopes; D007004:Hypoglycemic Agents; D007328:Insulin; D005719:gamma-Globulins; D016670:Gabexate