Imagama Takashi, Tokushige Atsunori, Sakka Akihito, Seki Kazushige, Taguchi Toshihiko
Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan.
Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan.
Taiwan J Obstet Gynecol. 2015 Jun;54(3):303-5. doi: 10.1016/j.tjog.2013.10.044.
Back and buttock pain during pregnancy and the postpartum period generally improves spontaneously and rarely causes problems. However, such pain is infrequently induced by pyogenic sacroiliitis.
We herein present a 37-year-old female patient with no previous medical history who developed pyogenic sacroiliitis with severe right buttock pain 7 days after cesarean delivery. Arthrocentesis was performed, and a culture revealed the presence of methicillin-resistant Staphylococcus aureus (MRSA). After 6 weeks of treatment with intravenous antibiotics, her infection became quiescent. Eight cases of pyogenic sacroiliitis during the postpartum period and seven cases during pregnancy have been reported, but most of the causative pathogens were methicillin-sensitive Staphylococcus or Streptococcus species.
This report describes the first case of postpartum pyogenic sacroiliitis caused by MRSA. The frequency of infection with MRSA has recently increased, and community-acquired MRSA, which affects even healthy young people, has also become a problem. Antibiotics for empirical therapy after a diagnosis of pyogenic sacroiliitis, including anti-MRSA antibiotics, should be carefully selected.
孕期及产后出现的腰背部和臀部疼痛通常会自行缓解，很少引发问题。然而，这种疼痛很少由化脓性骶髂关节炎引起。
我们在此介绍一名37岁、既往无病史的女性患者，她在剖宫产术后7天出现化脓性骶髂关节炎，并伴有严重的右臀部疼痛。进行了关节穿刺，培养结果显示存在耐甲氧西林金黄色葡萄球菌（MRSA）。经过6周的静脉抗生素治疗，她的感染得到控制。此前已报道过8例产后化脓性骶髂关节炎病例和7例孕期化脓性骶髂关节炎病例，但大多数致病病原体为对甲氧西林敏感的葡萄球菌或链球菌属。
本报告描述了首例由MRSA引起的产后化脓性骶髂关节炎病例。近年来，MRSA感染的频率有所增加，社区获得性MRSA甚至影响到健康的年轻人，这也成为了一个问题。对于诊断为化脓性骶髂关节炎后的经验性治疗抗生素，包括抗MRSA抗生素，应谨慎选择。
