Abstract
RATIONALE: Infectious sacroiliitis (ISI) is a rare infection of the sacroiliac joint, typically affecting adolescents and children. Its diverse and nonspecific clinical manifestations, along with often unremarkable early imaging findings, frequently lead to diagnostic delays and poor outcomes. This report presents a case of ISI caused by Staphylococcus aureus in a young female physician, aiming to enhance clinicians' awareness of ISI in atypical populations, emphasize the importance of early imaging and microbiological testing in diagnosis, and provide insights into the clinical management of this rare condition. PATIENT CONCERNS: A 29-year-old woman physician was admitted to our medical facility due to experiencing right hip pain for 5 days. The pain was characterized as constant and achy, not extending to other parts of the body, but intensifying notably when walking or bending. Resting provided some relief from the pain, and there was no significant discomfort on the left side. Additionally, she complained trouble walking and weakness in her right lower limb. DIAGNOSES: Accordingly, taking into account the patient's medical background, physical assessment, and findings from admission tests, a diagnosis was made of methicillin-sensitive staphylococcus aureus bacteremia and right-sided ISI. INTERVENTIONS: The patient received intravenous cefoperazone-sulbactam for a duration of 4 weeks as part of her anti-infection treatment regimen, with a dosage of 3.0 grams administered every 12 hours. OUTCOMES: Following 3 days of treatment, her pain levels decreased, enabling her to have some restricted movement. By the end of the first week, her body temperature normalized, her pain considerably lessened, and a subsequent blood culture came back negative. A follow-up magnetic resonance imaging of the sacroiliac joint 4 weeks later showed improvement in bone marrow edema specifically on the right side of the joint. LESSONS: ISI is a rare condition that can be quite challenging to diagnose due to its vague and nonspecific symptoms. magnetic resonance imaging is considered the most reliable imaging technique for identifying ISI when there is suspicion of the condition. Early identification of the specific bacterial strain based on drug sensitivity testing is crucial for the effective clinical management of ISI and for predicting the patient's prognosis.