An Uncommon Infection due to an Unusual Pathogen. Report of a Pubic Symphisis Septic Arthritis after Caesarean Delivery due to Cutibacterium Acnes.

Denes E, Saddiki R
Journal of obstetrics and gynaecology of India · 2025 · doi:10.1007/s13224-024-02085-2 · PMID:40390981 · PMC12085498
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⚙ AI-generated summary by claude@2026-07, 2026-07-29 ⓘ

This case report details a rare pubic symphysis septic arthritis following cesarean delivery caused by *Cutibacterium acnes*, which required prolonged antibiotic treatment and surgical intervention.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-16 · read from full text ⓘ

The paper reports a rare case of pubic symphysis septic arthritis occurring after cesarean delivery, attributed to the unusual pathogen Cutibacterium acnes. The authors describe management with three lines of antibiotic therapy and surgical debridement, noting that the commensal nature of the organism contributed to an erratic diagnosis lasting nearly six years, with chronic pain and pelvic girdle destabilization that ultimately required surgery. The case had no relapse after more than 18 months of follow-up, with the main limitation being that the evidence is a single-patient report. This paper is centrally about endometriosis and adenomyosis only tangentially; it does not explicitly discuss either condition and is included in the corpus via upstream keyword matching for pelvic pathology.

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Abstract

Pubic symphysis septic arthritis is a rare condition mainly associated with pregnancy. Fewer than 35 cases have been reported. We report a case that occurred after delivery by caesarean section, and which was due to Cutibacterium acnes. Management involved three lines of antibiotic therapy and surgical debridement. The combination of this rare pathology and a germ often considered commensal led to an erratic diagnosis for almost six years. One of the consequences, in addition to chronic pain, was destabilization of the pelvic girdle, necessitating surgery. After more than 18 months of follow-up, there was no relapse.
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Abstract

Pubic symphysis septic arthritis is a rare condition mainly associated with pregnancy. Fewer than 35 cases have been reported. We report a case that occurred after delivery by caesarean section, and which was due to Cutibacterium acnes. Management involved three lines of antibiotic therapy and surgical debridement. The combination of this rare pathology and a germ often considered commensal led to an erratic diagnosis for almost six years. One of the consequences, in addition to chronic pain, was destabilization of the pelvic girdle, necessitating surgery. After more than 18 months of follow-up, there was no relapse. Similar content being viewed by others

References

Hansen RL, Bue M, Borgognoni AB et al. Septic arthritis and osteomyelitis of the pubic symphysis—a retrospective study of 26 patients. J Bone Jt Infect. 2022;7:35–42. Elden H, Olsen MF, Hussein NF et al. Postpartum septic symphysitis, a rare condition with possible long-term consequences: a cohort study with long-term follow-up. BMC Pregnancy Childbirth. 2021;21:1–15. Achermann Y, Goldstein EJC, Coenye T et al. Propionibacterium acnes: from commensal to opportunistic biofilm-associated implant pathogen. Clin Microbiol Rev. 2014;27:419–40. Funding There is no funding source. Author information Authors and Affiliations Corresponding author Ethics declarations Conflict of interest There is no conflict of interest. Ethical Approval Not necessary. Informed Consent A written consent was obtained from the patient. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Eric Denes is a Infectiologie Specialist, M.D; Rachid Saddiki is a Orthopaedic and Spinal Surgeon, M.D. Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Denes, E., Saddiki, R. An Uncommon Infection due to an Unusual Pathogen. Report of a Pubic Symphisis Septic Arthritis after Caesarean Delivery due to Cutibacterium Acnes. J Obstet Gynecol India 75 (Suppl 1), 641–643 (2025). https://doi.org/10.1007/s13224-024-02085-2 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s13224-024-02085-2

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