Abstract
A 58-year-old woman with non-insulin dependent diabetes mellitus (NIDDM), who was not treated for 10 years, complained of sudden rt. hip joint pain when carrying heavy baggage. She then developed cyclic vomiting and a few days later her consciousness diminished. She was hospitalized and diagnosed as having diabetic ketoacidosis, disseminated intravascular coagulation syndrome and shock. Computed tomography showed multiple abscesses in muscles around the rt. sacroiliac joint. The abscesses were surgically drainaged. Cultures of the drained pus and blood cultures were positive for Prevotella bivia. On the second drainage operation, an abscess was also recognized at the sacro-iliac joint. She was thus diagnosed as having pyogenic sacroiliitis which secondarily caused multiple abscesses, sepsis and diabetic ketoacidosis.
Pyogenic sacroiliitis is an uncommon disease and its association with multiple muscle abscesses has not previously been described in the medical literature to our knowledge. In addition, this is the first report of Prevotella vibia as its pathogen. Pyogenic sacroiliitis and multiple muscle abscesses should be considered in poorly-controlled diabetic patients who complain of lumbago and have infectious signs.
