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Pubic pain after a marathon

1998; Elsevier BV; Volume: 351; Issue: 9103 Linguagem: Inglês

10.1016/s0140-6736(97)10470-6

1474-547X

Laurence Baril, Éric Caumes, François Bricaire,

Orthopedic Infections and Treatments

In April, 1997, 6 days after competing in his 12th marathon, a 40-year-old man was admitted to the hospital with a high fever. For the previous 24 h he had had acute pains in his thighs and in his pubic symphysis, which radiated to his groin and perineum. He had a fever of 40°C and marked tenderness over his symphysis pubis and his thighs, predominantly in his adductor muscles. He could not move on to his side because of the pain. There was no adenopathy in his groins, no skin lesions, and no lymphangitis. He had lost a toenail on his right foot during the race, but the nail bed had not become infected. He was on no medication and had had no previous serious illnesses. His white-cell count was 13·6×109/L with 93% segmented neutrophils, packed-cell volume was 46%, and C-reactive protein was 170 mg/L. Chest radiograph was normal. Blood was sent for culture on admission. On his second day in hospital, computed tomography of his pelvis and ultrasonography of his thighs were interpreted as normal. On a presumption of septicaemia, intravenous oxacillin and gentamicin were started. Next day, blood cultures yielded a Staphylococcus aureus strain susceptible to oxacillin, aminoglycosides, fluoroquinolones, rifampicin, fusidic acid, and glycopolypeptides.