A novel observation of pubic osteomyelitis due to Streptococcus viridans after dental extraction: a case report.
BACKGROUND
Pubic osteomyelitis should be suspected in athletic individuals with sudden groin pain, painful restriction of hip movements and fever. It is an infrequent and confusing disorder, which is often heralded by atypical gait disturbance and diffuse pain in the pelvic girdle. The most common pathogen is Staphylococcus aureus but, on occasions, efforts to identify infectious agents sometimes prove negative. Pubic osteomyelitis due to Streptococcus viridans has not been reported previously in the literature.


METHODS
We describe the case of a fit 24-year-old athlete, who had a wisdom tooth extracted 2 weeks prior to the presentation, which could have served as a port of entry and predisposed the patient to transient bacteraemia.


CONCLUSIONS
S. viridans is well known for causing infective endocarditis of native damaged heart valves, but to the best of the authors' knowledge it has not been reported previously as a cause of pubic osteomyelitis. We believe that this case should alert physicians to the association between dental procedures and osteomyelitis of the pubis secondary to S. viridans.
Naqvi
Naseem
N
Department of Acute Medicine, Dumfries & Galloway Royal Infirmary, UK. naseemnaqvi@doctors.org.uk
Naqvi
Rizwana
R
Wong
Christopher
C
Pearce
Sushmita
S