Post-traumatic untreated chronic osteomyelitis: an extreme presentation with severe complications

Description

An 89-year-old man presented to the hospital complaining of several episodes of lipotimia and non-specific malaise. Comorbidities included a right lower limb chronic osteomyelitis, as consequence of a trauma at the age of 12 years, with occasional bleeding, and which has never been medical or surgically treated before. He was haemodynamically stable with normal cardiac and pulmonary auscultation during the physical examination. The right lower limb revealed an extensive extremely putrefied and suppurative wound with bone exposition in which fragments could easily be removed (figure 1A,B). Considering the patient's complaints, a 12-lead ECG was performed and showed normal sinus rhythm with 2:1 atrioventricular block, ST-segment elevation in the inferior leads and V6 and ST-segment depression in V1, V2, aVL and aVR. Patient denied chest pain. The laboratory investigation revealed a microcytic and hypochromic anaemia with an Hb of 4.2 g/dL (reference range 13.5–17.0 g/dL) and...

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