Emphysematous osteomyelitis in hematological malignancies: tales of two cases

Emphysematous osteomyelitis (EOM) is defined as the presence of gas forming bacteria within bones. It is seen in patients with morbid conditions like immunosuppression, diabetes, patients on chemotherapy, in cancer patients and in intravenous drug abusers. We present two cases of emphysematous osteomyelitis in patients with hematological malignancies; lymphoma and leukemia. Both the patients had similar clinical presentations with fever, localized swelling, and pain. Both patients underwent sonography (USG) and contrast-enhanced computed tomography (CECT) and imaging diagnosis of EOM was made. Microbiological confirmation of the causative organism was done and patients were started on appropriate antibiotics. Both patients responded very well to the treatment. Imaging findings and treatment outcomes are discussed, highlighting the challenges in managing this rare complication.