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耻骨联合骨髓炎伴会阴部-耻骨联合瘘:一种难以诊断的疾病。

Pubic symphysis osteomyelitis with associated vesico-symphyseal fistula: a difficult diagnosis.

机构信息

Medical Student Affairs, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, USA

Medical Student Affairs, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, USA.

出版信息

BMJ Case Rep. 2021 Sep 20;14(9):e244336. doi: 10.1136/bcr-2021-244336.

DOI:10.1136/bcr-2021-244336
PMID:34544709
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8454438/
Abstract

Pubic symphysis osteomyelitis is an infectious complication that rarely arises in men who have undergone treatment for prostate cancer. This process may more rarely arise from a fistulous tract between the pubic symphysis and the urinary tract. In this case report, we discuss the most common clinical presentations and laboratory findings that lead to the diagnosis of this disease process, as well as the role of MRI and other imaging modalities in confirmation of the diagnosis. This case serves as a reminder to clinicians to have earlier consideration of pubic symphysis osteomyelitis in their differential diagnosis to reduce the risk of long-term complications associated with undertreatment.

摘要

耻骨联合骨髓炎是一种感染性并发症,在接受前列腺癌治疗的男性中很少发生。这种情况可能更罕见地源于耻骨联合和泌尿道之间的瘘管。在本病例报告中,我们讨论了导致这种疾病过程诊断的最常见临床表现和实验室发现,以及 MRI 和其他成像方式在确诊中的作用。本病例提醒临床医生在鉴别诊断中更早考虑耻骨联合骨髓炎,以降低治疗不足相关的长期并发症风险。

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Pubic symphysis osteomyelitis with associated vesico-symphyseal fistula: a difficult diagnosis.耻骨联合骨髓炎伴会阴部-耻骨联合瘘:一种难以诊断的疾病。
BMJ Case Rep. 2021 Sep 20;14(9):e244336. doi: 10.1136/bcr-2021-244336.
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本文引用的文献

1
Relapsed Symptoms in a Patient Treated for Pubic Symphysis Septic Arthritis/Adjacent Osteomyelitis: Diagnostic Challenges.一名接受耻骨联合化脓性关节炎/邻近骨髓炎治疗的患者的复发症状:诊断挑战
Case Rep Infect Dis. 2020 Nov 26;2020:8819268. doi: 10.1155/2020/8819268. eCollection 2020.
2
A Rare Paronychia with Superinfection with and : The Importance of Early Microbiological Diagnosis.一种罕见的伴有 和 二重感染的甲沟炎:早期微生物学诊断的重要性
Pathogens. 2020 Nov 29;9(12):999. doi: 10.3390/pathogens9120999.
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Symphysis Pubis Osteomyelitis: An Uncommon Complication after Robotic Assisted Radical Prostatectomy-Case Description with Literature Review.耻骨联合骨髓炎:机器人辅助根治性前列腺切除术后一种罕见的并发症——病例描述及文献综述
Case Rep Urol. 2018 Feb 13;2018:5648970. doi: 10.1155/2018/5648970. eCollection 2018.
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Osteitis pubis: A rare cause of suprapubic pain.耻骨炎:耻骨上区疼痛的罕见病因。
Rev Urol. 2017;19(3):156-163. doi: 10.3909/riu0767.
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Septic arthritis of the pubis symphysis: clinical and therapeutic features.耻骨联合化脓性关节炎:临床与治疗特点
Pan Afr Med J. 2017 Apr 24;26:215. doi: 10.11604/pamj.2017.26.215.12204. eCollection 2017.
6
Pubic Bone Osteomyelitis and Pubosymphyseal Urinary Fistula: A Poorly Recognized Complication in Prostate Cancer Survivors.耻骨骨髓炎和耻骨联合尿道瘘:前列腺癌幸存者中一种未被充分认识的并发症。
Oncology (Williston Park). 2017 Mar 15;31(3):169-73.
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The imaging of osteomyelitis.骨髓炎的影像学检查
Quant Imaging Med Surg. 2016 Apr;6(2):184-98. doi: 10.21037/qims.2016.04.01.
8
Fistulation into the Pubic Symphysis after Treatment of Prostate Cancer: An Important and Surgically Correctable Complication.前列腺癌治疗后耻骨联合瘘管形成:一种重要且可通过手术矫正的并发症。
J Urol. 2016 Feb;195(2):391-8. doi: 10.1016/j.juro.2015.08.074. Epub 2015 Aug 22.
9
Osteomyelitis pubis: a rare and elusive diagnosis.耻骨骨髓炎:一种罕见且难以诊断的病症。
West J Emerg Med. 2014 Nov;15(7):880-2. doi: 10.5811/westjem.2014.8.13401. Epub 2014 Oct 7.
10
Long-term complications in men who have early or late radiotherapy after radical prostatectomy.根治性前列腺切除术后接受早期或晚期放疗的男性的长期并发症。
Can Urol Assoc J. 2014 Jul;8(7-8):253-8. doi: 10.5489/cuaj.1764.