Katsolis, Jennifer

Abstract Osteomyelitis pubis, a rare form of osteomyelitis affecting the pubic bone and symphysis, is an often-misdiagnosed condition accounting for less than 1% of all osteomyelitis cases. We present the case of a 41-year-old-male diabetic patient on sodium-glucose-co-transporter-2 (SGLT2) inhibitors, specifically dapagliflozin, who developed osteomyelitis pubis and associated septic arthritis and pyomyositis. Despite a well-controlled diabetes profile and the absence of typical risk factors, the patient's condition progressed rapidly leading to severe pain and functional impairment. Imaging studies revealed extensive infection, and culture results identified Pseudomonas aeruginosa , necessitating a complex, multistage antibiotic regimen. The patient responded positively to treatment but experienced complications, including drug-induced agranulocytosis. This case underscores the potential link between SGLT2 inhibitors and osteomyelitis, highlighting the need for increased clinical vigilance and the careful assessment of risks when prescribing these medications to diabetic patients. Further research is warranted to better understand the association between SGLT2 inhibitors and osteomyelitis pubis.

AbstractBackgroundRecent studies have demonstrated that cytomegalovirus (CMV) infection and disease are associated with increased risk of graft loss and death in high‐risk (donor CMV seropositive/recipient CMV seronegative) liver transplant recipients (LTR) despite effective antiviral chemoprophylaxis. Predictors of CMV infection and disease in this important population are incompletely defined.MethodsA retrospective cohort study of 227 high‐risk first LTR who received primary anti‐CMV chemoprophylaxis during the first 100 days after transplant was performed. A large number of patient, donor, operative, and post‐transplant potential risk factors were collected. Associations of potential risk factors for CMV infection or disease that occurred during the first year after transplant were assessed using Cox regression models. After Bonferroni adjustment for multiple testing, P‐values ≤0.00125 (associations with CMV infection) and ≤0.00122 (associations with CMV disease) were considered as statistically significant.ResultsCMV infection and disease occurred in 91 (40%) and 43 (19%) of LTR, respectively. In multivariable analysis, increased risk of CMV infection was observed for patients with lower model for end‐stage liver disease (MELD) score (P = 0.025), lower total bilirubin (P = 0.014), and longer operative time (P = 0.038), whereas increased risk of CMV disease was seen in patients with lower MELD score (P = 0.026), lower total bilirubin (P = 0.044), and lower international normalized ratio (P = 0.043). However, after adjustment for multiple testing, none of these findings approached statistical significance.ConclusionOur results suggest that interventions designed to prevent CMV infection and disease should be applied to all high‐risk LTR until more definitive predictors of these complications are identified.