A rare case report of tuberculosis osteomyelitis of pubic symphysis

Abstract

Less than 2% of all hematogenous osteomyelitis occurs in the pubic symphysis, making it a very uncommon condition. 10-15% of all instances of extra-pulmonary tuberculosis are caused by skeletal TB. We describe a rare instance of pubic osteomyelitis caused by tuberculosis in a 58-year-old woman who initially complained of discharge in the suprapubic region for 8 months. Patient was admitted due to suspected pubic symphysis osteomyelitis caused by TB. Based on preoperative studies, surgery was planned. Due to a suspicion of tuberculosis, debridement was performed and stimulan antibiotic beads were inserted. CB-NAAT and histopathology samples were sent. When CB-NAAT tested positive for multidrug-resistant tuberculosis (MDR-TB) and started on antitubercular therapy (ATT), HPR indicated granulomatous inflammation. After receiving MDR-TB treatment, there was no discharge from the location. Following surgery, there was a year of follow-up. Patient made a full recovery without any site discharge. This example serves to illustrate our approach to treating pubic symphysis osteomyelitis caused by TB. Osteomyelitis of the pubic symphysis, stimulating antibiotic cement beads, CB-NAAT, MDRTB, ATT.