A 37-year-old female patient with no medical or family history had no particular problems during pregnancy. However, at 36 weeks of pregnancy, a nonreassuring fetal status was found, and her first child was born by cesarean delivery. She had no postoperative abnormalities, and the surgical wound site healed well.However, 7 days after surgery, right buttock pain developed with
no trigger. She visited the hospital because of the gradually worsening
buttock pain, gait disturbance, and fever. Her body temperature
was 38.4C, and severe tenderness was present in the right
buttock. A pelvic compression test was positive for the right
buttock. Blood testing showed a white blood cell level of
13.96 109/L, a left shift on the differential white blood count, and
a remarkably elevated C-reactive protein level of 220 mg/L. A pelvic
radiograph showed no remarkably abnormal findings such as
osteolysis or osteosclerosis (Fig. 1), but contrast-enhanced
computed tomography revealed enlargement of the right iliac
muscle and an abscess accompanied by ring-enhancing lesions
anteroposterior to the right sacroiliac joint (Fig. 2).
Magnetic resonance imaging centered on the right sacroiliac
jointwas performed. The T1-weighted image showed low intensity,
and the T2-weighted image revealed abnormal high intensity of the
bone marrow and a lesion believed to be an abscess 1.5 cm in
diameter in the region anteroposterior to the joint (Fig. 3). Based on
these results, the patient was diagnosed with pyogenic sacroiliitis.
X-ray-guided puncture of the sacroiliac joint and abscess was performed,
and approximately 2 mL of milketea-like puncture fluid
was collected. Culture of the puncture fluid revealed the presence
of MRSA. Blood and urine cultures were negative. After a 3-week
combined administration of vancomycin and rifampicin, a 3-week
administration of arbekacin was performed. Her symptoms subsequently
disappeared, her blood test results became normal, and
she was discharged from the hospital. One year after discharge, no
recurrence was observed, and she has a favorable prognosis.
37 岁女性患者没有医疗或家族的历史在怀孕期间有没有特别的问题。然而,在妊娠 36 周,胎儿的不安全状态被发现,和她第一个孩子出生的剖宫产分娩。她有无术后的异常,而且手术创面愈合良好。但是,7 天后手术,右臀部疼痛发展的没有触发器。她参观了医院由于逐渐恶化臀部疼痛、 步态紊乱和发热。她的体温为 38.4 ℃,并且严重的温柔是存在权臀部。盆腔压缩试验阳性的权利臀部。血液测试表明白细胞水平13.96 109/L,对微分的白血细胞计数,左的移位和显著提升的 C-反应蛋白水平的 220 毫克/升。盆腔射线照相显示,未发现明显异常如骨溶解或硬化 (图 1),但对比增强电脑断层显示扩大的右髂肌肉和伴有环形强化病变脓肿前后右骶髂关节 (图 2)。居中右骶髂关节的磁共振成像jointwas 执行。T1 加权图像显示低强度,和 T2 加权图像显示异常高强度骨髓和病变据说是脓肿 1.5 厘米直径在区域前后到接头 (图 3)。基于these results, the patient was diagnosed with pyogenic sacroiliitis.X-ray-guided puncture of the sacroiliac joint and abscess was performed,and approximately 2 mL of milketea-like puncture fluidwas collected. Culture of the puncture fluid revealed the presenceof MRSA. Blood and urine cultures were negative. After a 3-weekcombined administration of vancomycin and rifampicin, a 3-weekadministration of arbekacin was performed. Her symptoms subsequentlydisappeared, her blood test results became normal, andshe was discharged from the hospital. One year after discharge, norecurrence was observed, and she has a favorable prognosis.
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