{
  "abstract": "Extraintestinal Clostridioides difficile (Clostridium difficile) infection rarely involves bone and can mimic malignancy. A man in his 70s with chronic kidney disease presented with a longstanding, painless, fluctuant anterior lower leg mass without systemic or gastrointestinal symptoms. Imaging showed a proximal tibial lytic lesion and aspiration of a superficial collection grew C. difficile. Symptoms persisted despite 4 weeks of oral amoxicillin-clavulanate (875–125 mg every 12 hours) plus oral metronidazole (500 mg every 8 hours). MRI demonstrated chronic tibial osteomyelitis with cortical disruption and a contiguous intramedullary and soft tissue abscess consistent with a Brodie’s abscess. He underwent excisional debridement with dead-space management and local vancomycin, followed by prolonged pathogen-directed antimicrobials. Two deep intraoperative cultures again yielded rare C. difficile with negative aerobic and blood cultures. He improved without amputation and remained stable at 9-month follow-up.",
  "authors": [
    {
      "affiliations": [
        "Department of Internal Medicine, McLaren-Greater Lansing Hospital, Lansing, Michigan, USA",
        "Michigan State University, Lansing, Michigan, USA"
      ],
      "name": "Claire Russell"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, McLaren-Greater Lansing Hospital, Lansing, Michigan, USA",
        "Michigan State University, Lansing, Michigan, USA"
      ],
      "name": "Adam Bowen"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, McLaren-Greater Lansing Hospital, Lansing, Michigan, USA",
        "Michigan State University, Lansing, Michigan, USA"
      ],
      "name": "Jeffrey Wood"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, McLaren-Greater Lansing Hospital, Lansing, Michigan, USA",
        "Michigan State University, Lansing, Michigan, USA"
      ],
      "name": "Syed Feeroz"
    },
    {
      "affiliations": [
        "Karmanos Cancer Center, Lansing, Michigan, USA"
      ],
      "name": "Stephen Caucci"
    },
    {
      "affiliations": [
        "Infectious Disease, McLaren-Greater Lansing Hospital, Lansing, Michigan, USA"
      ],
      "name": "Chris Farnum"
    }
  ],
  "title": "Clostridioides difficile osteomyelitis presenting as a Brodie’s abscess of the tibia",
  "uid": "b37e6006-e2e5-5243-a82d-4ea639a94793"
}