Eskridge C, Longo S, Kwark J, Robichaux A, Begneaud W
Department of Obstetrics and Gynecology, Leonard J. Chabert Medical Center, Houma, LA, USA.
J Perinatol. 1997 Jul-Aug;17(4):321-4.
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.
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.
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.
耻骨骨髓炎是一种罕见的病症。其临床表现与耻骨炎相似，耻骨炎是一种自限性疾病。然而，耻骨骨髓炎需要强化静脉抗生素治疗，且常常需要手术才能治愈。
一名33岁、孕2产1（001）的菲律宾女性于1994年4月5日经阴道分娩一3802克重的婴儿。分娩过程因肩难产而复杂化。她产后出现牙痛脓肿和耻骨疼痛，行走时疼痛加剧，产后病程也因此变得复杂。产后第20天，她因阴阜和大阴唇出现大面积蜂窝织炎而前往急诊科。X线检查和骨扫描结果与耻骨骨髓炎相符。该患者对多种静脉抗生素治疗均无反应，需要进行手术清创。
对于任何行走时耻骨疼痛加剧的患者，都应考虑耻骨骨髓炎的诊断。适当的治疗包括静脉抗生素治疗，对于对抗生素无反应的患者，必要时进行手术清创。
