35 yr young male with uncontrolled diabetes and alcoholism, presented with history of swelling left arm for last 10 days. There was severe pain, redness and the swelling was gradually extending upto forearm region. However, there was no history of trauma or fever. The patient gave history of getting immunized for hepatitis B vaccine in the same arm. X ray of humerus was apparently normal. Blood investigations showed increased total leucocyte count with granulocytosis. The ESR and CRP were markedly elevated. MRI of the arm and forearm confirmed presence of acute osteomyelitis of humerus with abscess formation in medial aspect of arm and cellulitis in forearm. The patient was taken to operation theatre and incision and drainage was done using anterolateral approach. Approximately 250 ml of thick pus was drained and samples were taken for gram stain and culture sensitivity. The wound was thoroughly washed and drill holes were drilled in bone. Pus came from inside bone too. The holes were enlarged to from a cortical window and the bone canal was thoroughly washed.