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Acute Pyogenic Sacroiliitis Caused by Staphylococcus aureus without Predisposing Conditions
Soo-Youn Moon, M.D., Joonbeom Shin, M.D., Kyung-Yup Kim, M.D., Seok Yeon Kim, M.D., Soo-Young Moon, M.D., Song Mi Moon, M.D., and Mi Suk Lee, M.D.
Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, South Korea
Vol.39 Num.5 (p277~280)
Pyogenic sacroiliits is a rare disease and the diagnosis is difficult because of unawareness of the disease and nonspecific symptoms and signs mimicking septic hip, iliopsoas muscle abscess and herniation of intervertebral disk. There are some predisposing factors related to the disease like trauma, pregnancy, intravenous drug abuse and infection of other systems such as skin, genitourinary system and heart. Staphylococcus aureus is the most common causative bacteria. Here we describe a case of 27-year-old woman presented with acute onset of back and left buttock pain. Bone scintigraphy revealed increased uptake at left sacroiliac joint and computed tomography of the pelvis showed left sacroiliitis with left iliacus and iliopsoas abscess. There was no history of usual predisposing conditions. S. aureus was grown from blood cultures and the patient improved with 2 weeks of intravenous cefazolin followed by 4 weeks of oral clindamycin treatment.
Keywords : Sacroiliitis, Iliopsoas abscess, Staphylococcus aureus