INTRAOSSEOUS EMPHYSEMATOUS OSTEOMYELITIS OF THE PELVIS WITH MYOSITIS AND ABSCESS FORMATION IN A CHEMOTHERAPY PATIENT: A CASE REPORT

Intraosseous emphysematous osteomyelitis is a rare but serious bone infection characterized by the presence of gas within the medullary cavity, most often in patients with immunosuppression or diabetes. Its occurrence in the pelvis bone is exceptionally uncommon. We present a 54-year-old female with locally advanced breast carcinoma who, one week after completing her final chemotherapy cycle, developed progressive lower abdominal and bilateral lower limb pain, fever and difficulty in weight-bearing. Cross-sectional imaging (MRI and CT) revealed marrow edema with intramedullary gas locules in bilateral pelvic bones and proximal femur, along with peripherally enhancing collections in the right iliacus, psoas and pectineus muscles- consistent with myositis and intramuscular abscess formation. Blood cultures isolated Escherichia coli, sensitive to carbapenems. The patient was managed conservatively with intravenous meropenem for six weeks, supportive care, and physiotherapy without surgical debridement. She showed marked clinical and radiological improvement, with normalization of inflammatory markers. The case underscores the importance of maintaining a high index of suspicion for rare infectious complicationsin oncologic patients especially those immunocompromised presenting