Osteomyelitis of the symphysis pubis: a complication of cardiac catheterisation

We report a novel case of septic arthritis of the symphysis pubis due to Streptococcus pneumoniae and review 99 previously reported cases of infection of this joint. Typical features of pubic symphysis infection included fever (74%), pubic pain (68%), painful or waddling gait (59%), pain with hip motion (45%), and groin pain (41%). Risk factors included female incontinence surgery (24%); sports, especially soccer (19%); pelvic malignancy (17%); and intravenous drug use (15%). Septic arthritis of the pubic symphysis is often misdiagnosed as osteitis pubis, a sterile inflammatory condition. Causative organisms differed according to risk factors. Staphylococcus aureus was the major cause among athletes, Pseudomonas aeruginosa among intravenous drug users, and infections among patients with pelvic malignancies were usually polymicrobial, involving fecal flora. Patients with recent urinary incontinence surgery usually had monomicrobial infection, with no predominant pathogen. Since osteomyelitis is present in 97% of patients, we recommend antibiotic courses of 6 weeks' duration. Surgical debridement is required in 55% of patients.

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Septic Arthritis of the Pubic Symphysis

Ross

2003

Medicine

177

138

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Pubic Symphysis Osteomyelitis after Bilateral Laproscopic Hernia Repair: A Case Report and Review of Literature

Sinha¹,

Qureshi²,

Kumar³

et al. 2022

JOCR

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Introduction: Pubic symphysis osteomyelitis is a rare complication of hernia repair, it is easily mistaken for osteitis pubis (OP) which can lead to a significant delay in diagnosis and prolonged pain for the patient. Case Report: We present the case of a 41-year-old male who presented with complaints of diffuse low back pain, perineal pain for 8 weeks after bilateral laparoscopic hernia repair. The patient was initially considered to have OP and managed however pain did not relieve with treatment. There was tenderness in the ischial tuberosity only. At the time of presentation, X-ray revealed areas of erosion and sclerosis in the pubis with increased inflammatory markers. Magnetic resonance imaging showed an altered marrow signal in the pubic symphysis, edema in the gluteus maximus on the right side, and collection in the peri-vesical space. The patient was started on oral antibiotics for 6 weeks and clinicoradiological improvement was noted. Conclusion: Pubic osteomyelitis and OP show similar clinical presentations with contrasting treatments. Early identification and initiation of appropriate treatment can decrease morbidity and improve outcomes. Keywords: Pubic osteomyelitis, osteitis pubis, osteomyelitis after hernia repair

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Acute Osteomyelitis of the Pubic Symphysis Following Cardiac Catheterization

Cm¹,

Pw²,

Rd³

1997

Orthopedics

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Osteomyelitis of the symphysis pubis: a complication of cardiac catheterisation

Cited by 3 publications

References 17 publications

Septic Arthritis of the Pubic Symphysis

Septic Arthritis of the Pubic Symphysis

Pubic Symphysis Osteomyelitis after Bilateral Laproscopic Hernia Repair: A Case Report and Review of Literature

Acute Osteomyelitis of the Pubic Symphysis Following Cardiac Catheterization

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