Osteomyelitis Pubis Treated with Wedge Resection: A Case Report with 26-Year Follow-up and Literature Review.

Osteomyelitis pubis is a rare orthopedic infection, accounting for less than 1-2 percent of all hematogenous osteomyelitis. Osteomyelitis pubis generally affects children, elderly patients who have undergone genitourinary procedures, and parenteral drug users. Interestingly, cases of acute osteomyelitis pubis have also been documented in previously young, healthy athletes. The diagnosis is often difficult to differentiate from osteitis pubis, which is a self-limiting, painful inflammatory condition affecting the symphysis pubis. The authors report what is to our knowledge the first case of osteomyelitis pubis in a baseball player and provide a brief review of the literature. The patient was a previously healthy 18-year-old baseball player who presented with left groin pain after presumably straining his groin during a baseball game. Over the next 24 hours, he developed fever, chills, and left lower quadrant pain. He received IV antibiotics and was discharged from the hospital after clinical improvement. However, he returned six weeks later with increased groin pain, a 20-pound weight loss, and an inability to bear weight. Laboratory studies revealed an elevated white blood cell count and a bone scan demonstrated increased uptake at the symphysis pubis. The patient was taken to the operating room where a wedge-resection was performed and tissue cultures grew Staphylococcus aureus, confirming the diagnosis of osteomyelitis pubis. The patient recovered without complication postoperatively and played four years of college baseball. He was seen at a follow-up appointment 26 years later and demonstrated a normal physical exam with radiographic evidence of regeneration of the symphysis pubis without SI joint instability.