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Degheili JA, Mansour MM, Nasr RW. Symphysis Pubis Osteomyelitis: An Uncommon Complication after Robotic Assisted Radical Prostatectomy-Case Description with Literature Review. Case Rep Urol 2018; 2018:5648970. [PMID: 29666747 PMCID: PMC5831911 DOI: 10.1155/2018/5648970] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 01/18/2018] [Indexed: 11/18/2022] Open
Abstract
Prostate cancer is the most common solid cancer among American men. Although there are various modalities for treatment, including radical prostatectomy among many others, the former is, nevertheless, not without any accompanied complications. Other than the well-known surgical complications such as erectile dysfunction, urinary incontinence, and voiding dysfunction, osteomyelitis of the symphysis pubis is not a well-understood complication, with various hypotheses explaining its pathogenesis. Although osteomyelitis of the pubis symphysis has been reported after endoscopic urological procedures such as transurethral resection of the prostate, it has rarely been reported after robotic surgeries. We hereby report, to the best of our knowledge, the first osteomyelitis of the pubis symphysis, after robotic prostatectomy, in a patient with prostate cancer and no previous radiation therapy.
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Affiliation(s)
- Jad A. Degheili
- Division of Urology and Renal Transplantation, Department of Surgery, American University of Beirut Medical Center, Riad El-Solh, Beirut 1107 2020, Lebanon
| | - Mazen M. Mansour
- Division of Urology and Renal Transplantation, Department of Surgery, American University of Beirut Medical Center, Riad El-Solh, Beirut 1107 2020, Lebanon
| | - Rami W. Nasr
- Division of Urology and Renal Transplantation, Department of Surgery, American University of Beirut Medical Center, Riad El-Solh, Beirut 1107 2020, Lebanon
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2
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Acute osteomyelitis of the symphysis pubis after inguinal hernia surgery. Case Rep Rheumatol 2015; 2015:845867. [PMID: 25973280 PMCID: PMC4417991 DOI: 10.1155/2015/845867] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Revised: 04/01/2015] [Accepted: 04/02/2015] [Indexed: 11/17/2022] Open
Abstract
Osteomyelitis of pubic symphysis is infectious inflammatory condition of the symphysis pubis and rare complication of surgery around inguinal and groin region. It should be kept in mind in the differential diagnosis of lower pelvic pain and should be sought in cases of pelvic insufficiency fractures. Herein, we present a case of a 55-year-old man with osteomyelitis of the symphysis pubis following inguinal hernia surgery for diagnosis and management of this rare condition.
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Kim JY, Kim TH, Choo EJ, Jeon MH, Lee EJ, Kim JH, Park EJ, Lee JC, Jin SY. Experience of Osteomyelitis of the Pubic Symphysis Following Surgical Treatment of Perianal Necrotizing Fasciitis. Infect Chemother 2009. [DOI: 10.3947/ic.2009.41.3.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Ji Yon Kim
- Department of Internal Medicine, Soon Chun Hyang University Hospital, Seoul, Korea
| | - Tae Hyong Kim
- Department of Internal Medicine, Soon Chun Hyang University Hospital, Seoul, Korea
| | - Eun Ju Choo
- Department of Internal Medicine, Soon Chun Hyang University Hospital, Seoul, Korea
| | - Min Hyok Jeon
- Department of Internal Medicine, Soon Chun Hyang University Hospital, Seoul, Korea
| | - Eun Jeong Lee
- Department of Internal Medicine, Soon Chun Hyang University Hospital, Seoul, Korea
| | - Jong-Hwa Kim
- Department of Internal Medicine, Soon Chun Hyang University Hospital, Seoul, Korea
| | - Eui Ju Park
- Department of Internal Medicine, Soon Chun Hyang University Hospital, Seoul, Korea
| | - Jae Chul Lee
- Department of Orthopedic Surgery, Soon Chun Hyang University Hospital, Seoul, Korea
| | - So-Young Jin
- Department of Pathology, Soon Chun Hyang University Hospital, Seoul, Korea
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Dovas S, Liakopoulos V, Simopoulou T, Giannopoulou M, Kanaki A, Anifandis G, Stefanidis I. A case report of osteomyelitis pubis in a hemodialysis patient with diabetes mellitus. Ther Apher Dial 2008; 12:409-12. [PMID: 18937727 DOI: 10.1111/j.1744-9987.2008.00619.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Osteomyelitis pubis is a rare form of osteomyelitis. Known risk factors are urogynecologic surgery, trauma caused by sport activities, pelvic malignancy and intravenous drug use. Immunocompromised patients, including hemodialysis patients, and those with diabetes are also susceptible to infection. Particularly in the hemodialysis population, the use of intravenous catheters frequently results in bacteremia and metastatic infectious complications such as osteomyelitis. We describe the first case of osteomyelitis pubis in a woman on chronic maintenance hemodialysis with diabetes mellitus.
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Affiliation(s)
- Spiros Dovas
- Department of Nephrology, School of Medicine, University of Thessaly, Larissa, Greece.
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Abstract
Osteomyelitis can result from hematogenous or contiguous microbial seeding of the bone. Staphylococcus aureus is the most common infecting microorganism. Although any bone can potentially develop osteomyelitis, long-bone, vertebral, and foot osteomyelitis account for the majority of cases. Confirmatory diagnosis of osteomyelitis often depends on the results of a bone biopsy and bone cultures. Radiologic and laboratory studies are often helpful in leading to the diagnosis, determining the extent of the disease, and following up selected patients with osteomyelitis. Optimal therapy for osteomyelitis requires the collaboration of a multidisciplinary team of physicians. Debridement is often needed in contiguous osteomyelitis, whereas acute hematogenous and vertebral osteomyelitis can often be treated with a prolonged course of antimicrobial therapy.
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Affiliation(s)
- Irene G Sia
- Section of Orthopedic Infectious Diseases, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55902, USA
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Dourakis SP, Alexopoulou A, Metallinos G, Thanos L, Archimandritis AJ. Pubic osteomyelitis due to Klebsiella pneumoniae in a patient with diabetes mellitus. Am J Med Sci 2006; 331:322-4. [PMID: 16775440 DOI: 10.1097/00000441-200606000-00006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Osteomyelitis of the pubic symphysis or pubic osteomyelitis is a rare entity that is encountered in certain groups of people such as athletes, intravenous drug users, patients with pelvic malignancy, and patients who have undergone surgical manipulations of the genitourinary system. The most frequent causative organism is Staphylococcus aureus. K pneumoniae is a common pathogen in diabetic patients, but pubic osteomyelitis due to K pneumoniae has not previously been described. We present a diabetic patient with pubic osteomyelitis caused by K pneumoniae without known predisposing factors.
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Affiliation(s)
- Spyros P Dourakis
- Second Department of Medicine, University of Athens Medical School, Hippokration General Hospital, Athens, Greece
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Abstract
We report a novel case of septic arthritis of the symphysis pubis due to Streptococcus pneumoniae and review 99 previously reported cases of infection of this joint. Typical features of pubic symphysis infection included fever (74%), pubic pain (68%), painful or waddling gait (59%), pain with hip motion (45%), and groin pain (41%). Risk factors included female incontinence surgery (24%); sports, especially soccer (19%); pelvic malignancy (17%); and intravenous drug use (15%). Septic arthritis of the pubic symphysis is often misdiagnosed as osteitis pubis, a sterile inflammatory condition. Causative organisms differed according to risk factors. Staphylococcus aureus was the major cause among athletes, Pseudomonas aeruginosa among intravenous drug users, and infections among patients with pelvic malignancies were usually polymicrobial, involving fecal flora. Patients with recent urinary incontinence surgery usually had monomicrobial infection, with no predominant pathogen. Since osteomyelitis is present in 97% of patients, we recommend antibiotic courses of 6 weeks' duration. Surgical debridement is required in 55% of patients.
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Affiliation(s)
- John J Ross
- Division of Infectious Diseases, Caritas Saint Elizabeth's Medical Center, 736 Cambridge Street, Boston, MA 02135-2997, USA.
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Andonian S, Rabah DM, Aprikian AG. Pseudomonas aeruginosa sacroiliitis and osteomyelitis of pelvic bones after radical prostatectomy. Urology 2002; 60:698. [PMID: 12385945 DOI: 10.1016/s0090-4295(02)01862-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A 66-year-old diabetic man presented with acute incapacitating pelvic pain 6 weeks after radical prostatectomy. Symphysis pubis biopsy showed chronic osteomyelitis, and culture grew Pseudomonas aeruginosa. Despite a 7-week course of intravenous piperacillin and ceftazidime, he returned 6 months later with the same symptoms. Imaging studies and biopsy indicated right sacroiliitis and persistent pseudomonas osteomyelitis of the pelvic bones. He refused surgical debridement and was successfully treated with the same antibiotics for 8 more weeks. We emphasize the importance of bone biopsy and culture to expedite effective intravenous antibiotic therapy.
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Affiliation(s)
- Sero Andonian
- Division of Urology, Department of Surgery, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada
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Berthelot JM, Varin S, Caillon F, Prost A, Maugars Y. Pseudomonas aeruginosa osteomyelitis of both ischia: a case report. J Bone Joint Surg Am 2002; 84:441-4. [PMID: 11886916 DOI: 10.2106/00004623-200203000-00017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Pauli S, Willemsen P, Declerck K, Chappel R, Vanderveken M. Osteomyelitis pubis versus osteitis pubis: a case presentation and review of the literature. Br J Sports Med 2002; 36:71-3. [PMID: 11867499 PMCID: PMC1724464 DOI: 10.1136/bjsm.36.1.71] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
An athletic 23 year old man presented with suprapubic tenderness, fever, and raised inflammatory blood variables. A diagnostic laparoscopy was performed, with a presumed diagnosis of retrocaecal appendicitis, but no abnormalities were found, apart from free fluid in the pouch of Douglas. Imaging of the pubic area suggested bony infection and inflammation. Biopsy and culture confirmed the presence of Staphylococcus aureus, a very common pathogen. The final diagnosis was osteomyelitis pubis, an infectious disease, and osteitis pubis, an inflammatory disease.
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Affiliation(s)
- S Pauli
- Department of Abdominal Surgery, University of Antwerp, Middelheim General Hospital, Antwerp, Belgium.
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Kumar S, Lacy MQ. 59-year-old man with pelvic pain and hypergammaglobulinemia. Mayo Clin Proc 2001; 76:311-4. [PMID: 11243278 DOI: 10.4065/76.3.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- S Kumar
- Mayo Graduate School of Medicine, Mayo Clinic, Rochester, Minn 55905, USA
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Angel Sánchez L, Luis Ferrero O, Baraia-Etxaburu J, Zubero Z, Teira R, Muñoz J, Cisterna R, Miguel Santamaría J. [Fever and pain in the inguinal-pubic area of five month's duration]. Enferm Infecc Microbiol Clin 2001; 19:77-8. [PMID: 11333574 DOI: 10.1016/s0213-005x(01)72565-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- L Angel Sánchez
- Enfermedades Infecciosas. Hospital de Basurto. Bilbao. Vizcaya
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