title: Pubic Osteomyelitis in a Combat Training Soldier: A Case Report.
abstract: Infectious osteomyelitis of the symphysis pubis, known as pubic osteomyelitis is a rare condition with potentially devastating consequences. To the best of our knowledge, this article is the first reported case of a military trainee presenting with pubic osteomyelitis.
  
  
  
  We present a unique case of a patient who simultaneously suffered a combination of local recurrent stress to the symphysis pubis area, and slow-healing multiple palm and finger lacerations which probably acted as distant ports of bacterial entry that concomitantly led to his illness.
  
  
  
  The patient went through a 6-month period of a complex diagnostic process and an antibiotic treatment with strict activity limitations, after which a full recovery was achieved.
  
  
  
  Although rare, when treating combat trainees or athletes whose daily life combines extensive physical training and potential ports of entry for bacteria, the treating physician should be aware of the potential for infectious osteomyelitis. Understanding the pathophysiology described would aid physicians when taking the patient history, and conducting an appropriate physical examination. The combination of a relevant history, pubic pain, high fever, and skin lacerations should alert the physician to the possibility of pubic osteomyelitis. When considering prevention, along with a well-designed training course for both soldiers in training camps and athletes, the significance of hygiene and treatment of superficial wounds or skin abrasions cannot be overemphasized.
authors.affiliation: Orthopedic Department, Meir Medical Center, 59 Tchernichovsky Street, 44281 Kfar-Saba, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Segal
authors.affiliation: Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, 1 Emek-Haela Street, Ramat-Gan, Israel.
authors.forename: Iris
authors.initials: I
authors.lastname: Eshed
authors.affiliation: Orthopedic Department, Meir Medical Center, 59 Tchernichovsky Street, 44281 Kfar-Saba, Israel.
authors.forename: Niv
authors.initials: N
authors.lastname: Marom
authors.affiliation: Orthopedic Department, Meir Medical Center, 59 Tchernichovsky Street, 44281 Kfar-Saba, Israel.
authors.forename: Georgiy
authors.initials: G
authors.lastname: Gurman
authors.affiliation: Orthopedic Department, Meir Medical Center, 59 Tchernichovsky Street, 44281 Kfar-Saba, Israel.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Chen
authors.affiliation: Orthopedic Department, Meir Medical Center, 59 Tchernichovsky Street, 44281 Kfar-Saba, Israel.
authors.forename: Meir
authors.initials: M
authors.lastname: Nyska
authors.affiliation: Orthopedic Department, Meir Medical Center, 59 Tchernichovsky Street, 44281 Kfar-Saba, Israel.
authors.forename: Gideon
authors.initials: G
authors.lastname: Mann
authors.affiliation: Orthopedic Department, Meir Medical Center, 59 Tchernichovsky Street, 44281 Kfar-Saba, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Yaacobi
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000032:analysis; D002437:Cefazolin / Q000494:pharmacology / Q000627:therapeutic use; D004493:Education / Q000379:methods; D005334:Fever / Q000209:etiology; D056973:Four-Dimensional Computed Tomography / Q000379:methods; D006801:Humans; D022125:Lacerations / Q000150:complications; D007958:Leukocyte Count / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000472:pathogenicity; D008889:Military Personnel / Q000193:education*; D010019:Osteomyelitis / Q000175:diagnosis* / Q000503:physiopathology*; D011631:Pubic Symphysis / Q000503:physiopathology*; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D002097:C-Reactive Protein; D002437:Cefazolin