Background Osteitis pubis covers several different entities and may lead to nosologic confusion. Infectious osteitis pubis (IOP) should be used when underlying infection is found.
Objectives To analyse the main characteristics of IOP in a monocenter series.
Methods Retrospective study about IOP with analysis of clinical, biological, imaging, bacteriological and pathological features. Inclusion criteria: osteitis pubis with favourable outcome under antibiotics.
Results Twenty cases were analysed; 13 men,7 women; aged 16–77 years. IOP followed surgical procedure of the pelvis or urinary tract (8/20), was post-traumatic (2/20), regional infection related (3/20), or of unknown origin (7/20). Two cases of diabetes and one chronic steroid treatment were present. Pain was constant, with a delay in diagnosis of over 1 month. Elevated ESR(15/20), hyperleukocytosis (6/20), positive cultures of blood (3) or urine (4) were found. X-rays modifications were constant. Cultures of suppurative scars were positive in 4 cases, whereas cultures of pubis biopsies were positive in 1 out of 9 cases. Mononuclear subacute osteomyelitis was found histologically in 5/9 biopsies, without suppurative or necrotic changes. Outcome was favourable in all cases under antibiotics in a period of 1 to 12 months. Spine or sacro-iliac extension occured in 3 cases.
Conclusion IOP should be considered as a septic arthritis to reduce the delay in diagnosis and in instauration of targeted antibiotherapy.
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