Pubic symphysis osteomyelitis with associated vesico-symphyseal fistula: a difficult diagnosis

Pubic symphysis osteomyelitis is an infectious complication that rarely arises in men who have undergone treatment for prostate cancer. This process may more rarely arise from a fistulous tract between the pubic symphysis and the urinary tract. In this case report, we discuss the most common clinical presentations and laboratory findings that lead to the diagnosis of this disease process, as well as the role of MRI and other imaging modalities in confirmation of the diagnosis. This case serves as a reminder to clinicians to have earlier consideration of pubic symphysis osteomyelitis in their differential diagnosis to reduce the risk of long-term complications associated with undertreatment.