Septic arthritis of the pubic symphysis from Pseudomonas aeruginosa: reconsidering traditional risk factors and symptoms in the elderly patient. (24th August 2012)

• Record Type: Journal Article
• Authors: To, Fergus; Tam, Penny; Villanyi, Diane
• Is Part Of: BMJ case reports. Volume 2012
• Publication Date: 2012-08-24
• Subjects: Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2012-006777
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : A high-functioning 82-year-old man presented with lower lumbar pain and pubic tenderness. On admission he was afebrile with a normal white count. A grossly elevated C reactive protein was noted. CT scan of the pelvis showed a fluid collection anterior to the pubic symphysis and to the right of the midline measuring 2.0 × 2.2 cm. Pseudomonas aeruginosa was cultured from the fluid collection. The patient had no history of intravenous drug use, pelvic surgeries, malignancies or trauma. We report what we believe is the first documented case of P aeruginosa infection of the pubic symphysis in an elderly patient that did not have any of the traditional risk factors associated with neither P aeruginosa septic arthritis nor infections of the pubic symphysis. Instead, we propose that phimosis with chronic infection of the foreskin and balanitis may have led to septic arthritis.