Objective To investigate the clinical features of type 2 diabetes with pyogenic osteomyelitis to reduce the clinical misdiagnosis and missed diagnosis. Methods A case of type 2 diabetes mellitus with pyogenic osteomyelitis in our hospital were retrospectively analyzed. Results A 60-year-old male patient with type 2 diabetes for 7 years, suffered waist pain 2 months before and got fever for 1 month. Laboratory tests revealed the level of white blood cell,C reactive protein and Procalcitonin were elevated. The blood culture prompted Escherichia coli with evidence of sepsis. After the anti-infection treat-ment, the inflammatory indicators returned to normal and blood culture turned negative. But the patients followed progressive lower back pain in the course of disease and eased after bed rest. X rays and CT suggested lumbar degenerative diseases. Be-cause of low back pain symptoms and increased fever, the patient came to our hospital. We used intervertebral disc pathology to confirm the diagnosis of pyogenic osteomyelitis. After local surgery and anti-infection treatment, the patient recovered. Conclusion For diabetes with fever, low back pain patients should be alert to the possibility of consolidation of pyogenic os-teomyelitis. Clinicians should be based on diseases' change timely to avoid the disease missed or misdiagnosed.%目的 探讨2型糖尿病合并脊柱化脓性骨髓炎的临床特点,减少临床误漏诊.方法 对我院收治的以脓毒症首诊的2型糖尿病合并脊柱化脓性骨髓炎1例的临床资料进行回顾性分析.结果 本例有糖尿病史7年,因腰部疼痛2个月,反复寒战、高热1个月就诊,查白细胞计数、C-反应蛋白、降钙素原均升高,血培养提示大肠埃希杆菌生长,外院诊断为脓毒症,予抗感染治疗后患者炎性指标恢复正常.病程中患者逐渐出现腰痛,腰椎影像学检查提示腰椎退行性病变,卧床休息后缓解,后因腰痛症状逐渐加重并再发高热入我院.入我院后经椎间孔镜病理检查确诊为脊柱化脓性骨髓炎,予局灶清理术及抗感染治疗后临床治愈.结论 对于糖尿病伴发热、腰痛患者要警惕合并脊柱化脓性骨髓炎的可能,应根据疾病变化及时复查相关检查,避免误诊误治.
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