Bhat Vivek, Anandram Seetharam, Lobo Aaron C, Davis Ashika, John Deepa S
Internal Medicine & Hematology, St. John's Medical College, Bangalore, IND.
Radiology, St. John's Medical College, Bangalore, IND.
Cureus. 2021 Dec 22;13(12):e20599. doi: 10.7759/cureus.20599. eCollection 2021 Dec.
Osteomyelitis commonly involves the long bones, with pelvic involvement uncommon. We report the case of a 50-year-old male who, following a bone marrow biopsy that diagnosed him with non-Hodgkin's lymphoma, had persistent complaints of fever, swelling, and pain over the biopsy site. Pus cultures revealed growth of methicillin-resistant (MRSA), with computed tomography and magnetic resonance imaging of the pelvis revealing features of osteomyelitis of the right ilium. He was managed conservatively with antibiotics. On the last follow-up, he had just recovered from another flare of the infection. Bone marrow biopsy is a common tool in the hematologist's inventory. It is quite safe, with complications reported in less than 0.1% of all cases. Osteomyelitis of the pelvis following this is exceedingly rare; to our knowledge, only two prior such cases have been reported. Pelvic osteomyelitis is characterized by poorly defined hip pain, limited range of motion, and difficulty with ambulation. In case of intractable hip or buttock pain following a bone marrow biopsy, osteomyelitis of the pelvis must be considered in the differential diagnosis, and appropriate management must be begun. A multidisciplinary approach is required, with surgical debridement and appropriate antibiotics.
骨髓炎通常累及长骨，累及骨盆的情况并不常见。我们报告一例50岁男性病例，该患者在骨髓活检被诊断为非霍奇金淋巴瘤后，活检部位持续出现发热、肿胀和疼痛症状。脓液培养显示耐甲氧西林金黄色葡萄球菌（MRSA）生长，骨盆的计算机断层扫描和磁共振成像显示右髂骨骨髓炎的特征。他接受了抗生素保守治疗。在最后一次随访时，他刚从另一次感染发作中康复。骨髓活检是血液科医生常用的检查手段。它相当安全，所有病例中并发症报告发生率不到0.1%。此后发生骨盆骨髓炎极为罕见；据我们所知，此前仅报告过两例此类病例。骨盆骨髓炎的特征是髋部疼痛不明确、活动范围受限和行走困难。如果在骨髓活检后出现难治性髋部或臀部疼痛，在鉴别诊断中必须考虑骨盆骨髓炎，并必须开始适当的治疗。需要采取多学科方法，进行手术清创并使用适当的抗生素。
