Clinical noteAcute Bacterial Sacroiliitis in an Adult: A Case Report and Review of the Literature
Section snippets
Case Description
A 40-year-old woman without significant medical history presented to our clinic with a 2-week history of pain in the left gluteal region. She said her pain began after she lurched forward while carrying her luggage at the airport. The pain was sharp and progressed over the next several hours while she was on the aircraft, prompting her to seek an evaluation in the emergency department. Radiographs showed no abnormalities in the pelvis and hip. The patient was treated for a muscle strain and was
Discussion
Bacterial septic sacroiliitis is more typically seen in children and young adults than in middle-aged or elderly persons.5 In adults, there is often a history of intravenous drug use, skin and respiratory infections, or genitourinary tract infections. It is thought that the majority of septic sacroiliitis cases occur through hematogenous seeding from a preexisting infection from a distant site.2, 5 Others have suggested it is the result of local spreading of infection from a spinal or pelvic
Conclusions
Infectious SIJ disease can be difficult to diagnose, given the nonspecific symptoms and physical examination findings. Clinicians should be aware of the diagnosis, however, even in the acute setting or in unilateral cases. With appropriate laboratory and imaging workup, the appropriate treatment can be initiated without delay and without any long-term complications. As was true for our patient, the proper identification of bacterial septic sacroiliitis frequently leads to a positive outcome.
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Cited by (21)
Septic sacroiliitis in the post-partum period with haematogenous spread
2021, IDCasesCitation Excerpt :In a review of 15 patients in the pregnant/postpartum period by Imagama et al. only 3 cases were managed with open drainage with a further single patient requiring a hysterectomy and oophorectomy [8]. Septic sacroiliitis remains an important differential given immunosuppression of pregnancy and hypothesised hormonal effects on joint laxity; albeit limited, literature certainly suggests pregnancy may be an independent risk factor for its development [6–8,12]. The case presented here represents another rare presentation of septic sacroiliitis with disseminated infection and haematogenous spread adding to a small but significant number of patients making septic sacroiliitis a differential to always consider in the post-partum patient presenting with non-resolving, severe pelvic pain.
Septic sacroiliitis in the late postpartum due to Escherichia coli
2016, Revista Colombiana de ReumatologiaSacroiliitis and gluteal abscess secondary to Staphylococcus aureus infection
2015, Reumatologia ClinicaBenign osseous and articular abnormalities of the pelvis: A review of CT imaging findings
2015, Clinical ImagingCitation Excerpt :It is more typically seen in children and young adults than in the middle-aged or older adults. Diagnosis is often difficult due to the nonspecific clinical presentation [8]. Infection of the SI joint may occur via hematogenous seeding or from local extension of an infectious process.
Profile of infectious sacroiliitis among rheumatology inpatients in Lomé (Togo): A single center experience
2014, Egyptian RheumatologistCitation Excerpt :Infectious sacroiliitis is rare, involving between 1% and 2% of septic arthritis cases, which is probably due to the poor vascularization of this joint resulting in a low risk of infection via the haematogenous route [1,2]. Most observations are based on single case reports and review of the literature [3–8], small case series [9,10] or multicentre studies [11]. The diagnosis of osteoarticular infection is difficult in these anatomical sites and may be delayed due to the poor specificity of clinical signs and symptoms [1,12–14].
What is Your Radiologic Diagnosis?
2022, Cocuk Enfeksiyon Dergisi
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