Multidisciplinary management of patients with pubic osteomyelitis, a rare but serious complication after surgery and radiation therapy for advanced gynaecological cancer.
Ilse HavemanAnne M van AltenaCharlotte Pa VerschurenJohanna Wilhelmina Maria AartsPublished in: BMJ case reports (2021)
Pubic osteomyelitis is a rare and often late-onset complication of radiation therapy and surgery for vulvar and vaginal carcinoma. It typically presents with vulvar pain, fever, vaginal discharge and/or gait disorders. Pubic osteomyelitis is often accompanied by fistulas or wound dehiscence in the pelvic area. Its accurate diagnosis and treatment are challenging and require a multidisciplinary team effort. In our patients, multiple combined surgical procedures, long-term antibiotic treatment and days to weeks of hospital admission were necessary to treat pubic osteomyelitis. We emphasise the importance of timely and adequate diagnosis and multidisciplinary approach resulting in a course of treatment that is as effective as possible, limiting the impact on quality of life, which is generally high in this group of patients.
Keyphrases
- late onset
- end stage renal disease
- radiation therapy
- ejection fraction
- newly diagnosed
- chronic kidney disease
- prognostic factors
- early onset
- minimally invasive
- healthcare
- squamous cell carcinoma
- early stage
- spinal cord
- palliative care
- lymph node
- coronary artery disease
- atrial fibrillation
- young adults
- combination therapy
- patient reported
- acute coronary syndrome
- drug induced
- neoadjuvant chemotherapy