Suspected Septic Sacroiliitis Following Recent Cesarean Section Under Spinal Anesthesia

Aratara A Nutcharoen; Ahmed A Salih; Andrew Volio; Alexis Skolaris; Sabry Ayad

doi:10.7759/cureus.8891

Suspected Septic Sacroiliitis Following Recent Cesarean Section Under Spinal Anesthesia

Cureus. 2020 Jun 28;12(6):e8891. doi: 10.7759/cureus.8891.

Authors

Aratara A Nutcharoen¹, Ahmed A Salih¹, Andrew Volio², Alexis Skolaris³, Sabry Ayad^{4

5

3}

Affiliations

¹ Anesthesiology, Cleveland Clinic Fairview Hospital, Cleveland , USA.
² Outcomes Research, Cleveland Clinic , Cleveland, USA.
³ Outcomes Research, Cleveland Clinic, Cleveland, USA.
⁴ Anesthesiology, Cleveland Clinic Fairview Hospital, Cleveland, USA.
⁵ Anesthesiology, Cleveland Clinic, Cleveland, USA.

Abstract

Septic sacroiliitis is sacroiliac (SI) joint inflammation secondary to microbial invasion of the synovial space characterized by tenderness over the sacroiliac joint, difficulty walking, and lower back pain that can radiate to the buttocks. Clinicians can easily overlook septic sacroiliitis as a potential diagnosis due to its rare occurrence and non-specific symptoms. A 30-year-old female (G2P2A0) who presented acutely to the ED nine days after an uncomplicated Cesarean section performed under spinal anesthesia. The patient experienced progressive lancinating, electric-shock pain originating from the coccyx radiating to the right buttock and lower back with the inability to bear weight. MRI pelvis demonstrated edematous changes of the right SI joint, indicative of septic sacroiliitis. Patient's condition improved after empiric intravenous antibiotics and was discharged home on the continued intravenous course. Rapid empiric administration of intravenous antibiotics may have prevented the onset of severe complications of an infective SI joint.

Keywords: cesarean section; mobility limitation; pyogenic sacroiliitis; sacroiliac joint; sacroiliitis; septic sacroiliitis; spinal anesthesia.

Publication types

Case Reports