Pyogenic Sacroilihis in Qatar

Abstract

We describe our experience in handling six cases of pyogenic sacroiliitis. Two were males and four were females with a mean age of 24.9 years. None had a history of i.v. drug abuse. Blood cultures were positive in half of the patients. The sacroiliac joint aspirate was positive in one additional patient. Staphylococcus aureus was recovered from three of four culture positive cases. Bone and CT scans revealed abnormalities in all patients. Response to antibiotic therapy was satisfactory in all except one patient who had an early relapse. Early diagnoses and proper treatment would result in improved outcomes.

Pregnancy‐Associated Pyogenic Sacroiliitis: Case Report and Review

“…The onset of illness was during pregnancy in six cases (40%) 1,4,6,10,11 (including this case) within 3 weeks of delivery in six instances (40%) 3,5,[7][8][9] and within 3 weeks of abortion in three cases (20%) 7,11,12 . Among the postpartum cases, forceps outlet delivery was utilized in one case, 9 days prior to presentation 9 .…”

“…In addition, delivery was complicated by an episode of chills and bleeding within 24 hours of vaginal delivery in one case 5 , and by high fever with disseminated intravascular coagulopathy and fetal distress in another case 5 . Among the three post-abortion cases, termination of pregnancy was spontaneous in one case 12 , induced but incomplete in one case 11 , and followed induction due to fetal death in the other case 7 . Possible risk factors were identified in eight patients (53.3%), including injection drug use (n = 3; 20%) 1,3,10 , infective endocarditis (n = 2; 13%) 4,10 , urinary tract infection (n = 3; 20%) 1,6,10 , endometritis (n = 2; 13%) 5,11 and extensive sinusitis requiring multiple irrigations in the pre-antibiotic era 11 .…”

“…Our findings demonstrate that without proper diagnosis and treatment, the infection frequently extends to the periarticular structures 11,12 . In addition, in cases that involved preterm labor or fetal death, it is uncertain whether joint infection preceded, coincided with or followed these obstetric events 3,7,11 . The pathogenesis of the condition is suspected to be hematogenous.…”

Acute Pyogenic Sacroiliitis Without Predisposing Conditions

“…However, bone scanning may return negative results if performed too early after the onset of symptoms. 7,25,[27][28][29] The main disadvantage of scintigraphy is its inability to differentiate sacroiliitis from psoas or gluteal abscess and to identify the spread of infection from the joint into surrounding tissues. 11,13 Computed tomography is also nondiagnostic in the early stages of the condition when there is no cortical erosion, joint effusion is minimal, and there is inflammation of the muscle without abscess formation.…”

Sacroiliitis caused by Salmonella typhi

“…Stool and synovial fluid cultures were positive approximately 35% and 42%, respectively; ESR and CRP were also elevated in most cases [4]. The results of positive cultures in reported cases of SI caused by S. typhi can be seen in Table 1 [6,[13][14][15][16][17]. In our case, blood cultures were positive, and stool, synovial aspiration and abscess cultures were negative.…”