Bilateral and symmetrical osteomyelitis due to gram-negative bacilli. A report on two cases

Gram-negative bacillary osteomyelitis secondary to sepsis is a rare condition. It most frequently attacks the vertebrae, occasionally in the long bones, and can on occasion be multiple. We present 2 patients with severe sepsis of urinary origin who, after a latent period, developed bilateral and symmetrical osteomyelitis due to the same microorganism that caused the sepsis. We discuss this peculiar presentation, its possible pathogenetic mechanism and the need to consider osteomyelitis in the presence of bilateral and symmetrical arthritis after an episode of severe sepsis.