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Multidisciplinary management of patients with pubic osteomyelitis, a rare but serious complication after surgery and radiation therapy for advanced gynaecological cancer
  1. Ilse Haveman1,
  2. Anne M van Altena1,
  3. Charlotte PA Verschuren1 and
  4. Johanna WM Aarts2
  1. 1Obstetrics and Gynaecology, Radboudumc, Nijmegen, Gelderland, The Netherlands
  2. 2Amsterdam UMC, Amsterdam, The Netherlands
  1. Correspondence to Dr Johanna WM Aarts; j.w.m.aarts{at}amsterdamumc.nl

Abstract

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.

  • cancer - see oncology
  • cancer intervention
  • infections
  • gynaecological cancer
  • radiotherapy

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Footnotes

  • Contributors JA and AvA planned the study including conception, design and acquisition of data and interpretation of data and reporting. IH and CPAV contributed in design, data collection, interpretation and reporting/write up.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.