Pyogenic infections of the pubic symphysis

Four cases of Pseudomonas aeruginosa infection of the pubic symphysis occurred in intravenous abusers of pentazocine hydrochloride and pyribenzamine. Symptoms included suprapubic pain when walking, bilateral inguinal pain, and pain caused by hip flexion and rotation. Cultures of material taken by joint aspiration and open biopsy yielded P. aeruginosa in three patients and P. aeruginosa, P. maltophilia, and Corynebacterium in the fourth. All four responded to antibiotic treatment and open debridement but were lost to follow-up. Recent reports of P. aeruginosa arthritis in intravenous drug abusers are discussed. The concept of infective synchondritis as a distinct entity is suggested.