Back ground: Multifocal infective osteomyelitis with simultaneous presentation in multiple bones is very rare. Specially in patients without sickle cell anaemia. We present a case of multifocal infective osteomyelitis in an otherwise healthy female. Presentation: The patient presented with bilateral thigh pain of 3 months duration with no constitutional symptoms. The thighs were tender on palpation and on blood investigations a raised leucocyte count was observed. Radiology showed sequestrae in both femurs. MRI imaging also showed bone destruction and oedema in the bilateral femoral diaphysis. Management: She was diagnosed as multifocal osteomyelitis and underwent saucerization and prophylactic fixation. The pus and sequestra were sent for culture and sensitivity and revealed Enterococci infection. She then underwent antibiotic therapy and prophylactic fixation for both femurs. She also developed similar symptoms in her humerus, which resolved with conservative management. Take away: This is a first reported case of multifocal infective osteomyelitis of simultaneous onset and reaffirms the need for early diagnosis and surgical intervention both for debridement and prophylactic fixation. It also establishes the role of accurate culture and rational antibiotic therapy in management of such cases.
