Osteomyelitis Masquerading as Cellulitis: A Case Report

TL;DR

A case of osteomyelitis was initially mistaken for cellulitis, highlighting the need for careful diagnosis and combined treatment approaches.

Contribution

This case report highlights the diagnostic challenge of osteomyelitis masquerading as cellulitis and emphasizes the importance of timely intervention.

Findings

Osteomyelitis was misdiagnosed as cellulitis despite initial treatment with ceftriaxone.

CT scan confirmed pretibial abscess and osteomyelitis caused by Escherichia coli.

Surgical debridement and six weeks of intravenous antibiotics improved patient outcomes.

Abstract

Osteomyelitis, a significant global healthcare issue, often results from infections related to open fractures, surgery, or conditions like diabetic foot ulcers. This report describes a case of osteomyelitis in a 62-year-old female with various pre-existing health conditions. The patient initially presented with swelling, pain, and difficulty walking in the right lower extremity, accompanied by systemic symptoms. Despite an initial diagnosis of cellulitis and treatment with ceftriaxone, a subsequent CT scan revealed a pretibial abscess and confirmed osteomyelitis caused by pan-sensitive Escherichia coli. Surgical debridement was performed, and the patient received six weeks of intravenous antibiotics. Hence, a heightened level of suspicion is essential to facilitate a timely diagnosis of osteomyelitis and enhance long-term prognosis. The case underscores the importance of a multidisciplinary approach, including meticulous surgical intervention and tailored antimicrobial therapy, in achieving positive outcomes for osteomyelitis patients.

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