Abstract
IntroductionPubic osteomyelitis should be suspected in athletic individuals with sudden groin pain, painful restriction of hip movements and fever. It is an infrequent and confusing disorder, which is often heralded by atypical gait disturbance and diffuse pain in the pelvic girdle. The most common pathogen is Staphylococcus aureus but, on occasions, efforts to identify infectious agents sometimes prove negative. Pubic osteomyelitis due to Streptococcus viridans has not been reported previously in the literature.Case presentationWe describe the case of a fit 24-year-old athlete, who had a wisdom tooth extracted 2 weeks prior to the presentation, which could have served as a port of entry and predisposed the patient to transient bacteraemia.ConclusionS. viridans is well known for causing infective endocarditis of native damaged heart valves, but to the best of the authors' knowledge it has not been reported previously as a cause of pubic osteomyelitis. We believe that this case should alert physicians to the association between dental procedures and osteomyelitis of the pubis secondary to S. viridans.
Highlights
Pubic osteomyelitis should be suspected in athletic individuals with sudden groin pain, painful restriction of hip movements and fever
S. viridans is well known for causing infective endocarditis of native damaged heart valves, but to the best of the authors' knowledge it has not been reported previously as a cause of pubic osteomyelitis
We believe that this case should alert physicians to the association between dental procedures and osteomyelitis of the pubis secondary to S. viridans
Summary
Pubic osteomyelitis is a challenging diagnostic dilemma. We believe that this novel observation should alert physicians to the association between dental procedures and pubic osteomyelitis due to S. viridans. It is important to take a history of dental extraction in all patients who present with fever and pelvic pain. It is important to investigate patients with MRI scans as X-rays are neither sensitive nor specific enough for detecting osteomyelitis. Changes in plain radiographs of the pubic bone usually appear only several weeks after the clinical presentation of osteomyelitis and are not reliable in making the diagnosis. Diagnosis and treatment can prevent subsequent deformities of the pelvic bones and morbidity due to chronic osteomyelitis and joint deformities
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