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Unusual underlying cause of recurrent vulval abscess
Debarati Dutta1, Wael Agur, Calum Macleod
1Crosshouse Hospital, Obstetrics and Gynaecology, Crosshouse, Kilmarnock KA2 0JP, UK.
BMJ Case Reports
|March 31, 2012
Summary
A recurrent vulval abscess in an ex-intravenous drug user led to the diagnosis of pubic osteomyelitis. Prompt antibiotic treatment resulted in significant improvement and recovery, with no infections since.
Area of Science:
- Infectious Diseases
- Orthopedics
- Gynecology
Background:
- A patient with a history of intravenous drug use presented with recurrent vulval abscesses over two years.
- These abscesses necessitated multiple incision and drainage procedures.
Purpose of the Study:
- To report a case of pubic osteomyelitis secondary to recurrent vulval abscesses.
- To highlight the diagnostic and treatment course for this rare complication.
Main Methods:
- Pelvic X-ray was utilized for diagnosis.
- Treatment involved a combination of intravenous and oral antibiotics (ciprofloxacin and clindamycin).
Main Results:
- Imaging revealed widening of the symphysis pubis, irregularities, and severe erosive changes consistent with osteomyelitis.
- The patient responded well to a 2-week intravenous and 6-week oral antibiotic regimen.
- Significant clinical improvement was observed with no recurrence of infection.
Conclusions:
- Pubic osteomyelitis is a potential complication of recurrent vulval infections, particularly in at-risk populations.
- Aggressive antibiotic therapy can lead to successful treatment and recovery.
- Close orthopedic follow-up is recommended for patients with pubic osteomyelitis.
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