Pelvic osteomyelitis complicating Crohn's disease

Abstract

Although rheumatologic complications of Crohn's disease are common, osteomyelitis associated with Crohn's disease rarely is described. In this report, a 29-year-old man with Crohn's disease was seen with ileorectal fistula, pelvic abscess and severe back pain. The abscess and fistula were treated surgically but the patient had persistent fever and pain. Computed tomography scan showed destruction of the sacrum, and bone scan demonstrated increased sacral uptake. Osteomyelitis was suspected and confirmed on bone biopsy. Streptococcus viridans was isolated from bone culture. Treatment with parenteral penicillin was successful and follow-up revealed no recurrence of osteomyelitis.