Sacroileítis infecciosa secundaria a un absceso del iliopsoas ­ reporte de un caso / Infectious sacroiliitis secondary to an iliopsoas abscess ­ a case report

La sacroileítis infecciosa (SII), también descrita en la literatura como sacroileítis séptica o piógena, es una patología infrecuente, y su diagnóstico constituye un reto debido a su rareza relativa y la diversa presentación clínica, que frecuentemente imita otros trastornos más prevalentes originados en estructuras vecinas. Se requiere un alto índice de sospecha y un examen físico acucioso para un diagnóstico oportuno, mientras que los estudios de laboratorio y de imagen ayudan a confirmar el diagnóstico y dirigir la estrategia de tratamiento apropiada para evitar complicaciones y secuelas a corto y mediano plazos. Presentamos un caso de paciente de género femenino de 36 años, con cuadro clínico de SII izquierda, secundaria a un absceso del músculo iliopsoas, condición que generalmente se presenta como una complicación de la infección. Se realizaron los diagnósticos clínico, imagenológico y Biológico, se inició el tratamiento antibiótico oportuno, y se logró una excelente evolución clínica, sin secuelas

Infectious sacroiliitis (ISI), also described in the literature as septic or pyogenic sacroiliitis, is an infrequent pathology, and its diagnosis constitutes a challenge due to its relative rarity and the diverse clinical presentation, frequently imitating other more prevalent disorders originating in neighboring structures. A high index of suspicion and a thorough physical examination are required in order to establish an opportune diagnosis, while laboratory and imaging studies help confirm the diagnosis and direct the appropriate treatment strategy to avoid complications and sequelae in the short and medium terms. We herein present a case of a female patient aged 36 years, with a clinical picture of left ISI, secondary to an iliopsoas muscle abscess, a condition that usually presents as a complication of the infection. The clinical, imaging and microbiological diagnoses were made, the timely antibiotic treatment was initiated, and an excellent clinical evolution without sequelae was achieved.

A Case of Acupuncture-induced Infectious Sacroiliitis / 대한류마티스학회지

Infectious sacroiliitis is an uncommon disease and the diagnosis is very difficult due to unawareness of the disease. The predisposing conditions to the disease are pelvic trauma, respiratory or genitourinary infection, skin infection, pregnancy, endocarditis, intravenous drug abuser and recent dental manipulation. The clinical characteristics of the disease are fever, leukocytosis, pain and tenderness of buttock, gait disturbance and positive result of blood culture and imaging study of sacroiliac joint. To our knowledge, the acupuncture induced infectious sacroiliitis with bacteremia is one of the rarely reported cases. We have recently experienced a case of infectious sacroiliitis as a very unusual complication of the acupuncture. In this case, increased signal intensity in the SI joint was found in the MRI, and focal hot uptake in SI joint was observed in bone scan. Staphyolococcus areus were cultured in the blood sample. Under the diagnosis of infectious sacroiliitis with bacteremia, the antibiotics was administered, and the clinical symptoms and laboratory findings were completely improved. This case report emphasizes that an acupuncture is a predisposing factor of the infectious sacroiliitis with bacteremia.