{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T13:22:30Z","timestamp":1783084950866,"version":"3.54.6"},"reference-count":17,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,6,19]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>\n                    Extraintestinal\n                    <jats:italic>Clostridioides difficile<\/jats:italic>\n                    (\n                    <jats:italic>Clostridium difficile<\/jats:italic>\n                    ) 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\n                    <jats:italic>C. difficile<\/jats:italic>\n                    . Symptoms persisted despite 4 weeks of oral amoxicillin-clavulanate (875\u2013125\u2009mg 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\u2019s 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\n                    <jats:italic>C. difficile<\/jats:italic>\n                    with negative aerobic and blood cultures. He improved without amputation and remained stable at 9-month follow-up.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2026-272562","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T12:55:39Z","timestamp":1783083339000},"page":"e272562","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["<i>Clostridioides difficile<\/i>\n                    osteomyelitis presenting as a Brodie\u2019s abscess of the tibia"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3082-5580","authenticated-orcid":false,"given":"Claire","family":"Russell","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, McLaren-Greater Lansing Hospital, Lansing, Michigan, USA"},{"name":"Michigan State University, Lansing, Michigan, 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