title: Postpartum pyogenic sacroiliitis with methicillin-resistant Staphylococcus aureus in a healthy adult: A case report and review of the literature.
abstract: OBJECTIVE
  Back and buttock pain during pregnancy and the postpartum period generally improves spontaneously and rarely causes problems. However, such pain is infrequently induced by pyogenic sacroiliitis.
  
  
  METHODS
  We herein present a 37-year-old female patient with no previous medical history who developed pyogenic sacroiliitis with severe right buttock pain 7 days after cesarean delivery. Arthrocentesis was performed, and a culture revealed the presence of methicillin-resistant Staphylococcus aureus (MRSA). After 6 weeks of treatment with intravenous antibiotics, her infection became quiescent. Eight cases of pyogenic sacroiliitis during the postpartum period and seven cases during pregnancy have been reported, but most of the causative pathogens were methicillin-sensitive Staphylococcus or Streptococcus species.
  
  
  CONCLUSIONS
  This report describes the first case of postpartum pyogenic sacroiliitis caused by MRSA. The frequency of infection with MRSA has recently increased, and community-acquired MRSA, which affects even healthy young people, has also become a problem. Antibiotics for empirical therapy after a diagnosis of pyogenic sacroiliitis, including anti-MRSA antibiotics, should be carefully selected.
authors.affiliation: Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan. Electronic address: taka-ima@interlink.or.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Imagama
authors.affiliation: Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Atsunori
authors.initials: A
authors.lastname: Tokushige
authors.affiliation: Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Sakka
authors.affiliation: Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Kazushige
authors.initials: K
authors.lastname: Seki
authors.affiliation: Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Taguchi
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002585:Cesarean Section; D005260:Female; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus; D049590:Postpartum Period; D058566:Sacroiliitis / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000150:complications* / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents
keywords: conservative treatment; healthy adult; methicillin-resistant Staphylococcus aureus; postpartum; pyogenic sacroillitis