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Case Reports
. 2017 Mar 31:2017:bcr2016217005.
doi: 10.1136/bcr-2016-217005.

Successful treatment of multidrug-resistant Pseudomonas aeruginosa pubic symphysis osteomyelitis with ceftolozane/tazobactam

Kari E Kurtzhalts  1 , Kari A Mergenhagen  1 , Akshay Manohar  1   2 , Charles S Berenson  1   2
Affiliations
Case Reports

Successful treatment of multidrug-resistant Pseudomonas aeruginosa pubic symphysis osteomyelitis with ceftolozane/tazobactam

Kari E Kurtzhalts et al. BMJ Case Rep. .

Abstract

New antibiotic options are needed for the treatment of multidrug-resistant (MDR) Pseudomonas infections. We present a case of a man aged 64 years with a bladder fistula due to radiation, ultimately causing osteomyelitis of the pubic symphysis. Repeated antibiotic courses, without correcting the fistula, resulted in infection with MDR Pseudomonas aeruginosa. He was successfully treated for his osteomyelitis through cystectomy, aggressive debridement and a prolonged course of antimicrobials directed at the MDR Pseudomonas isolate.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
MRI of the lower pelvis (T2-weighted, fat-suppressed) demonstrated an anterior bladder defect with a fluid signal from the bladder to the symphysis pubis (arrow).
Figure 2
Figure 2
MRI of the lower pelvis (T2-weighted, fat-suppressed) demonstrated oedema at the symphysis pubis (arrow), consistent with osteomyelitis. Circumferential thickening of the bladder wall related to chronic inflammation was also present.
See this image and copyright information in PMC

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