Concurrent Presentation of Emphysematous Pyelonephritis, Emphysematous Osteomyelitis, and Psoas Abscesses

Emphysematous pyelonephritis (EPN) is an uncommon necrotizing infection commonly seen in people with diabetes. Emphysematous osteomyelitis (EOM) is a rare form of pyogenic osteomyelitis characterized by the presence of air in the bones. A combination of both these infections has been reported only thrice in the literature. We present the case of a middle-aged diabetic woman who had both these rare infections along with psoas abscesses, a phenomenon that has been described only once previously. The patient required prolonged hospitalization, surgical debridement and drainage, a double-J stent, and meropenem, and she subsequently achieved full recovery.