Pyogenic Clavicular Osteomyelitis Associated with Disseminated Intravascular Coagulation and Acute Renal Failure in a Patient with Non-Insulin-Dependent Diabetes Mellitus

Pyogenic osteomyelitis is often accompanied by diabetes, but the disease in the clavicula has rarely been reported. We describe an unusual case of a 53-year-old man with poorly controlled noninsulin-dependent diabetes mellitus who presented with pyogenic clavicular osteomyelitis and developed DIC and acute renal failure. A 67Ga scintigram revealed an abnormal accumulation of the isotope in the right clavicula, where magnetic resonance imaging (MRI) showed inflammatory changes. This suggests that a 67Ga scintigram and MRI are of clinical value for the early diagnosis of the disease. Antibiotic chemotherapy with γ-globulin and gebexate mesilate, and hemodialysis almost cured his serious condition. (Internal Medicine 36: 810-814, 1997)