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Vulvar ulcer causing osteomyelitis of the pubic bone.
Bina Cohen-Sacher1, Yaa Amankwah, Paul S Cederna
1Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel. bina.cohensacher@gmail.com
Journal of Lower Genital Tract Disease
|February 21, 2013
Summary
This case report details a rare instance of severe pubic bone osteomyelitis originating from a vulvar ulcer in a patient with multiple sclerosis and diabetes. The complex treatment involved extensive surgery and prolonged antibiotics.
Area of Science:
- Urogynecology
- Infectious Disease
- Orthopedic Surgery
Background:
- Osteomyelitis of the pubic bone is uncommon, with risk factors including trauma, surgery, intense exercise, and immunosuppression.
- Treatment varies from antibiotics to radical surgical intervention.
Observation:
- A 49-year-old woman with multiple sclerosis and diabetes presented with bloody vulvovaginal discharge due to a vulvar ulcer exposing the symphysis pubis.
- Biopsies confirmed osteomyelitis of the pubic bone.
Findings:
- The patient required multiple surgical debridements and prolonged intravenous antibiotics to manage the severe pubic bone osteomyelitis.
- A bulbocavernosus flap was used for defect closure.
Implications:
- This case highlights a novel presentation of pubic bone osteomyelitis originating from a vulvar ulcer.
- It underscores the importance of considering rare infectious etiologies in complex pelvic presentations.
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