A 62-year-old woman with a 14-year history of insulin-treated diabetes mellitus initially visited a hospital due to lumbago and pain in the right knee joint with fever, followed by abrupt loss of right vision due to vitreous opacity. Both blood and joint fluid culture were positive for pneumococcus and magnetic resonance imaging (MRI) revealed a low-intensity lumbar lesion. Based on these findings, she was diagnosed as having pyogenic vertebral osteomyelitis, pyogenic arthritis of the knee joint, and metastatic bacterial endophthalmitis with pneumococcal sepsis. Immediate administration of antibiotics and vitreous surgery improved her condition. Immediate diagnosis and timely treatment are required to improve prognosis in these cases, and physicians should keep in mind that diabetic patients who have symptoms of lumbago, pain in the joints, and acute loss of vision with fever may have these infectious diseases.
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