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Pubic symphysis osteomyelitis associated with costal osteitis caused by Staphylococcus aureus after trauma: A case
Raghda Bouazra1, Afef Feki2, Imen Sellami3
1Rheumatology Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia.
Abstract:
Osteomyelitis of the pubic symphysis is a rare infectious disease commonly caused by the opportunistic bacteria Staphylococcus aureus and Pseudomonas aeruginosa. The clinical context includes fever, and pubic, or abdominal pain, thus should prompt a biological, microbiological, and radiological assessment. We report the case of a 16-year-old patient who developed inflammatory pygalgia in a febrile context laboratory examination showed an elevation of C-reactive protein and sedimentation rate. Pelvic X-rays and magnetic resonance showed bilateral bone lysis and destruction of the edges of the pubic symphysis, in addition to a pubic pelvic collection. Bacteriological examination revealed by methicillin-sensible S. aureus. The patient was put on antibiotic therapy for 2 months with good clinical and radiological evolution without surgical debridement. In conclusion, osteomyelitis of pubic symphysis can be misdiagnosed because of its atypical manifestations. Recovery is often achieved if adequate treatment is started early.
Insights
Osteomyelitis of the pubic symphysis, a rare infection often caused by Staphylococcus aureus, requires prompt diagnosis. Early antibiotic treatment can lead to recovery without surgery.
Area of Science:
- Infectious Diseases
- Orthopedics
- Radiology
Background:
- Osteomyelitis of the pubic symphysis is a rare infectious condition.
- Commonly caused by Staphylococcus aureus and Pseudomonas aeruginosa.
Observation:
- A 16-year-old presented with fever and inflammatory pygalgia (pelvic pain).
- Elevated C-reactive protein and sedimentation rate were noted.
- Imaging revealed bone lysis, pubic symphysis destruction, and a pelvic collection.
Findings:
- Bacteriological examination identified methicillin-susceptible Staphylococcus aureus.
- The patient received 2 months of antibiotic therapy.
- Clinical and radiological improvement was observed without surgical intervention.
Implications:
- Pubic symphysis osteomyelitis can present atypically, leading to misdiagnosis.
- Early and adequate antibiotic treatment is crucial for successful recovery.
- This case highlights the importance of a comprehensive diagnostic approach.
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