Segal David, Eshed Iris, Marom Niv, Gurman Georgiy, Chen Jacopo, Nyska Meir, Mann Gideon, Yaacobi Eyal
Orthopedic Department, Meir Medical Center, 59 Tchernichovsky Street, 44281 Kfar-Saba, Israel.
Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, 1 Emek-Haela Street, Ramat-Gan, Israel.
Mil Med. 2017 Mar;182(3):e1840-e1842. doi: 10.7205/MILMED-D-16-00171.
Infectious osteomyelitis of the symphysis pubis, known as pubic osteomyelitis is a rare condition with potentially devastating consequences. To the best of our knowledge, this article is the first reported case of a military trainee presenting with pubic osteomyelitis.
We present a unique case of a patient who simultaneously suffered a combination of local recurrent stress to the symphysis pubis area, and slow-healing multiple palm and finger lacerations which probably acted as distant ports of bacterial entry that concomitantly led to his illness.
The patient went through a 6-month period of a complex diagnostic process and an antibiotic treatment with strict activity limitations, after which a full recovery was achieved.
Although rare, when treating combat trainees or athletes whose daily life combines extensive physical training and potential ports of entry for bacteria, the treating physician should be aware of the potential for infectious osteomyelitis. Understanding the pathophysiology described would aid physicians when taking the patient history, and conducting an appropriate physical examination. The combination of a relevant history, pubic pain, high fever, and skin lacerations should alert the physician to the possibility of pubic osteomyelitis. When considering prevention, along with a well-designed training course for both soldiers in training camps and athletes, the significance of hygiene and treatment of superficial wounds or skin abrasions cannot be overemphasized.
耻骨联合感染性骨髓炎，即耻骨骨髓炎，是一种罕见疾病，可能产生严重后果。据我们所知，本文是首例报道的患有耻骨骨髓炎的军事训练学员病例。
我们介绍了一例独特病例，该患者耻骨联合区域同时遭受局部反复应激，且手掌和手指多处裂伤愈合缓慢，这些裂伤可能成为细菌进入的远处入口，进而导致患病。
患者经历了为期6个月的复杂诊断过程及严格限制活动的抗生素治疗，之后实现了完全康复。
尽管罕见，但在治疗日常生活中既有大量体育训练又有细菌进入潜在入口的战斗训练学员或运动员时，治疗医生应意识到感染性骨髓炎的可能性。了解所述病理生理学在采集患者病史和进行适当体格检查时对医生有帮助。相关病史、耻骨疼痛、高热和皮肤裂伤的组合应提醒医生注意耻骨骨髓炎的可能性。在考虑预防时，除了为训练营中的士兵和运动员设计完善的训练课程外，卫生以及浅表伤口或皮肤擦伤的治疗的重要性再怎么强调也不为过。
