Pubic osteomyelitis: Epidemiology and factors associated with treatment failure


To describe the epidemiology of pubic osteomyelitis (PO) and to look for factors associatedwith treatment failure.


Retrospective study describing PO according to outcome: success or failure of initial man-agement. Factors associated with failure determined by univariate Cox analysis. Kaplan-Meier curvecompared between groups by log-rank test.Results. – Twenty-five patients were included over a 13-year period; 24% of PO had blood-borne infection.Failure (44%) was always observed in chronic postoperative presentations (76%). Fistula (32%) was onlyobserved in postoperative presentations and was significantly associated with failure (HR 5.1; P = 0.011).Other risk factors were pelvic malignant tumor history, abscess, infection due to extended-spectrumbeta-lactamase-producing Enterobacteriaceae, and polymicrobial infection.


PO is most often a chronic postoperative polymicrobial infection in patients with comorbidi-ties at high risk of relapse. Studies in larger cohorts could assess the efficacy of more aggressive surgicalstrategies in patients at high risk of failure.