Pyogenic Sacroiliitis due to Group A Streptococcus following Uncomplicated Pregnancy and Vaginal Delivery

Abstract EN

Background.

Although the incidence of pregnancy-associated pyogenic sacroiliitis is low, it is associated with significant morbidity and mortality.

Timely diagnosis of the condition is challenging due to its nonspecific clinical features.

Case.

A 31-year-old primigravida had an uncomplicated pregnancy and labour.

Postpartum, she developed persistent fever and debilitating hip pain on ambulation.

White cell count was normal (7.3 × 109/L) and C-reactive protein was elevated (468.4 mg/L).

Streptococcus pyogenes was identified on vaginal swabs and blood cultures, and a pelvic magnetic resonance imaging scan revealed bilateral sacroiliitis.

Conclusion.

Pyogenic sacroiliitis is a potentially lethal cause of postpartum pain.

It should be considered as a differential diagnosis even in low-risk women who present with debilitating pelvic pain in or around pregnancy, particularly when initial therapy appears unsuccessful.