A novel observation of pubic osteomyelitis due to Streptococcus viridans after dental extraction: a case report

Naseem Naqvi¹ , Rizwana Naqvi² , Christopher Wong³ and Sushmita Pearce⁴

¹Department of Acute Medicine, Dumfries & Galloway Royal Infirmary, UK

²Department of Medicine, Macclesfield District General Hospital, East Cheshire NHS Trust, UK

³Department of Renal Medicine, Aintree University Hospitals NHS Trust, Liverpool, UK

⁴Department of Medicine, Royal Albert Edward Infirmary, Wigan, UK

author email corresponding author email

Journal of Medical Case Reports 2008, 2:255doi:10.1186/1752-1947-2-255


Published:	31 July 2008

Abstract

Introduction

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.

Case presentation

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.

Conclusion

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.