Postpartum Bilateral Sacroiliitis caused by Brucella Infection

Area of Science:

• Infectious Diseases
• Rheumatology
• Obstetrics & Gynecology

Background:

• Septic sacroiliitis presents nonspecific symptoms during the postpartum period, complicating early diagnosis.
• Brucellosis is a zoonotic infection that can affect multiple organ systems, including the musculoskeletal system.

Observation:

• A 31-year-old woman experienced severe bilateral buttock pain in the second week postpartum, unresponsive to pain relief and rest.
• Pelvic X-ray showed no abnormalities, but sacroiliac MRI revealed bone marrow edema and fluid in bilateral sacroiliac joints.
• The patient was seropositive for brucellosis, confirmed by a positive Rose Bengal test.

Findings:

• The patient was diagnosed with Brucella sacroiliitis, a rare but serious complication of brucellosis.
• Complete recovery was achieved with appropriate antibiotic therapy.
• Breastfeeding was discontinued upon positive brucellosis diagnosis.

Implications:

• Brucella sacroiliitis should be considered in the differential diagnosis of postpartum women presenting with severe, intractable buttock pain and gait disturbance.
• Prompt diagnosis and treatment are crucial for favorable outcomes and preventing long-term complications.
• This case highlights the importance of considering infectious etiologies, even with nonspecific symptoms, in the postpartum period.