Osteomyelitis pubis occurring after spontaneous vaginal delivery: a case presentation.

BACKGROUND

Osteomyelitis pubis is an uncommon disorder. The clinical presentation is similar to that of osteitis pubis, which is a self-limiting condition. However, osteomyelitis pubis necessitates intensive intravenous antibiotic therapy and, frequently, surgery to effect a cure.

CASE: A 33-year-old gravida II para 1001, Filipina vaginally delivered a 3802 gm baby on April 5, 1994. The delivery was complicated by shoulder dystocia. Her postpartum course was complicated by an abscessed tooth and pubic pain that was exacerbated by ambulation. On the twentieth postpartum day, she came to the emergency department with massive cellulitis of the mons veneris and labia majora. The results of an x-ray examination and bone scan were consistent with osteomyelitis of the pubis. The patient did not respond to multiple intravenous antibiotics, and surgical debridement was required.

CONCLUSIONS

A diagnosis of osteomyelitis pubis should be considered for any patient who experiences pubic pain that is exacerbated by walking. Proper therapy consists of intravenous antibiotics and surgical debridement, as necessary, in patients who do not respond to antibiotics.