A 64-year-old man with schizophrenia presented with 2 days of fever and buttock pain. Examination revealed a temperature of 37.8 °C and buttock erythema without an open wound. Computed tomography demonstrated soft tissue gas throughout the left lower extremity and buttock (Fig. 1a), extending into the left neural foramen (i.e., the exit space for nerve roots of the spinal canal, Fig. 1b). The patient’s condition deteriorated rapidly and he was transitioned to comfort care, as surgical intervention was deemed futile.
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