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AB0942 Pyogenic Infections of the Pubic Symphysis: Clinical and Therapeutic Features
  1. Z. Alaya1,
  2. I. Henchiri1,
  3. H. Zaghouani2,
  4. K. Baccouche1,
  5. S. Belghali1,
  6. D. Amri1,
  7. H. Zeglaoui1,
  8. E. Bouajina1
  1. 1Rheumatology department
  2. 2Radiology department, Hospital Farhat Hached, SOUSSE, Tunisia

Abstract

Background Septic arthritis of the pubis symphysis is rare and difficult to diagnose. It follows in most cases pelvis surgery or delivery.

Objectives The objective of our study was to describe the biological, therapeutic, clinical and radiological aspects of pyogenic infections of the pubic symphysis.

Methods This is a retrospective study of 4 cases of pyogenic infections of the pubic symphysis collected in the Department of Rheumatology over a period of 14 years [2000-2014].

Results Our population consists of 3 women and one men. The mean age was 47 years [18-83]. No comorbidity was recorded. Clinical signs of appeal were inflammatory groin pain, pubic pain and fever. Symptoms appeared 2 weeks after forceps delivery complicated by infectious endometritis in 2 cases, after surgery on the pelvis in one case and in a context of sepsis in one case. Walking was impossible in 2 cases. The mobilization of the hips and the pressure at the pubic symphysis were painful. The biological inflammatory syndrome was present in all cases. Plain radiographs showed pubic disjunction with irregular shoreline. CT performed in 2 patients and MRI performed in 2 patients, confirmed the pubic symphysite with an infiltration of the soft parts and soft parts abscess in all cases. A puncture biopsy of the pubic symphysis under CT was performed in all patients. The causative organisms were isolated in 3 cases by biopsy of soft tissue abscess in 2 cases and vaginal swab in one case. Identified germs were staphylococcus aureus Méti-S (n=1), proteus mirabilis (n=1) and varied flora (n=1). The treatment consisted of appropriate antibiotics in all cases and surgical drainage of soft tissue abscess resistant to medical treatment in 2 cases. The outcome was favorable in all cases.

Conclusions Septic arthritis of the pubic symphysis should be suspected in patients with inflammatory groin pain, pubic pain and fever especially after delivery and pelvic surgery.

Disclosure of Interest None declared

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