Fusobacterium osteomyelitis associated with intraosseous gas.

The diagnosis of acute anaerobic osteomyelitis was made in a 57-year-old hypertensive diabetic woman complaining of groin pain and fever. Roentgenograms and computed tomography demonstrated intraosseous gas in the right femoral head and surrounding soft tissue. Cultures obtained from open biopsy were positive for the anaerobic gram-negative bacillus Fusobacterium necrophorum, a normal inhabitant of the mouth, bowel, and urogenital tract. The patient responded to an antibiotic regimen of metronidazole combined with initial debridement and drainage, followed by resection of the femoral head (Girdle-stone arthroplasty). The hospital course was complicated by fungal and pseudomonal superinfection. The patient was afebrile and ambulatory at discharge two months after admission. A case of Fusobacterium necrophorum osteomyelitis causing intraosseous gas seems not to have been previously reported in the literature.