Aerococcus urinae infection of the pubic symphysis: A rare case report

Abstract

Aerococcus urinae is a Gram-positive, catalase-negative coccus, rarely responsible for urinary tract infections and seldom described for musculoskeletal infections like spondylodiscitis. An 86-year-old man presented to our hospital for groin pain without fever. Pelvic CT-guided biopsy revealed an A. urinae pubic symphysis osteomyelitis. He received a treatment by amoxicillin per os for six weeks, and did not need any surgery. An eight -month- follow-up showed a favorable evolution. Pubic symphysis infection can be induced by a wide variety of pathogens, and may have very different clinical presentations. Some authors recommend systematic surgery, but in case of susceptible pathogen associated with a low level of joint destruction, medical treatment alone should be sufficient to cure and make surgery unnecessary.

Keywords: Aerococcus urinae; Osteomyelitis; Pubic symphysitis; Septic arthritis.

Fig. 1

Osteolytic lesion of the cortical of the anteromedial part of the left pubic symphysis in the initial CT-scanner.

Fig. 2

A. Subchondral abscess on a coronal section MRI. B. Abscessed collection of the left obturator muscle on a coronal section MRI. C. Abscesses on an axial section on T2 MRI. D. Abscesses on an axial section on T1 MRI.

Fig. 3

Favorable evolution of symphysis osteomyelitis on a CT-scan performed two months after antimicrobial therapy initiation.