Pubic Symphysis Osteomyelitis after Bilateral Laproscopic Hernia Repair: A Case Report and Review of Literature

INTRODUCTION: Pubic symphysis osteomyelitis is a rare complication of hernia repair, it is easily mistaken for osteitis pubis (OP) which can lead to a significant delay in diagnosis and prolonged pain for the patient. CASE REPORT: We present the case of a 41-year-old male who presented with complaints of diffuse low back pain, perineal pain for 8 weeks after bilateral laparoscopic hernia repair. The patient was initially considered to have OP and managed however pain did not relieve with treatment. There was tenderness in the ischial tuberosity only. At the time of presentation, X-ray revealed areas of erosion and sclerosis in the pubis with increased inflammatory markers. Magnetic resonance imaging showed an altered marrow signal in the pubic symphysis, edema in the gluteus maximus on the right side, and collection in the peri-vesical space. The patient was started on oral antibiotics for 6 weeks and clinicoradiological improvement was noted. CONCLUSION: Pubic osteomyelitis and OP show similar clinical presentations with contrasting treatments. Early identification and initiation of appropriate treatment can decrease morbidity and improve outcomes.