A Case of Acute Pyogenic Sacroiliitis and Bacteremia Caused by Community-Acquired Methicillin-ResistantStaphylococcus aureus

Abstract

Pyogenic sacroiliitis is a rare osteoarticular infection, occurring most frequently in children and young adults. Diagnosis of the disease is challenging because of a general lack of awareness of the disease and its nonspecific signs and symptoms. Staphylococcus aureus is the most common causative bacteria in pyogenic sacroiliitis. Methicillin-resistant S. aureus (MRSA) has typically been considered a hospital-associated pathogen; however, community-acquired (CA)-MRSA infections are becoming increasingly common in Korea. We report the first domestic case of acute pyogenic sacroiliitis with abscess and bacteremia caused by CA-MRSA. The pathogen carried the type IV-A staphylococcal cassette chromosome mec (SCCmec) without the Panton-Valentine leukocidin (PVL) gene, and was identified as sequence type (ST) 72 by multilocus sequence typing.

Pyogenic Sacroiliitis and Multilocular Abscess Involving the Sacroiliac Joints in a Patient with Lumbar Pain

“…The most frequent symptom is lumbogluteal pain and the diagnosis is difficult because of the lack of symptom specifity. Staphylococcus aureus is the most detected organism in cases of pyogenic sacroiliitis [1,2]. In our case, the abscess was drained with percutaneous surgical approach and the patient responded well to antibiotic therapy.…”

“…Pyogenic sacroiliitis of sacroiliac joint is seen rarely, representing 1-2% of all cases of septic arthritis [1]. The most frequent symptom is lumbogluteal pain and the diagnosis is difficult because of the lack of symptom specifity.…”

A case report on the development of sacroiliitis post laparoscopic appendicectomy for acute appendicitis: a rare cause of sacroiliitis in an adult

“…Clinically, patients with acute sacroiliitis can present with fever, low back pain, gluteal or hip pain and abdominal pain. Differential diagnosis includes hip septic arthritis, lumbar disc or pelvic abscess [ 19 ]. MRI is the best diagnostic modality in comparison with CT scan and should be obtained for patients with symptoms suggestive of sacroiliitis [ 15 ].…”

“…By comparison, staphylococcus aureus -induced appendicitis is extremely rare and has been reported in less than 3.7 % of cases [ 13 ]. In contrast, staphylococcus aureus septicaemia is often seen in acute pyogenic sacroiliitis [ 19 ].…”

Pyogenic Sacroiliitis in a Pediatric Patient: A Rare Case of Infection by Streptococcus intermedius

“… 6 MRI of the pelvis is the most sensitive and specific image study for PS. 1 , 3 , 4 , 10 – 12 Many studies conclude that clinical and laboratory findings in association with changes seen on MRI are sufficient to establish the diagnosis of septic sacroiliitis without joint aspiration biopsy. 2 , 6 …”