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Pelvic MRI during the acute episode showed right-predominant sacroiliac joint effusion and marrow edema with erosions and adjacent myofascial edema. Serology confirmed brucellosis, and antibiotic therapy led to complete recovery with symptom remission over 3 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is septic arthritis difficult to diagnose in postpartum patients?","Question",{"text":63,"@type":64},"Postpartum presentations are often non-specific, and symptoms can be easily misinterpreted, which makes early diagnosis challenging.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What did pelvic MRI show during the acute pain episode?",{"text":68,"@type":64},"MRI revealed mild bilateral sacroiliac joint effusion, predominantly on the right, with bone marrow edema in the right sacral and iliac aspects, plus articular erosions and adjacent myofascial edema.",{"name":70,"@type":61,"acceptedAnswer":71},"How was the patient treated and what was the outcome?",{"text":72,"@type":64},"Serology confirmed brucellosis, and the patient completely recovered with antibiotic therapy, with significant symptom remission during a 3-month 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[homepage:](homepage: www.elsevier.com/locate/idcases)[ www.elsevier.com/locate/idcases](homepage: www.elsevier.com/locate/idcases)  \n| Case report\u003Cbr>Unilateral septic sacroiliitis caused by Brucella Melitensis in the postpartum period: A rare case report\u003Cbr>Sai Pavan lagishetty a,1,2, Tarun Kumar Suvvarib,c,*,2 , Ridhinayani Nalam c,d,3,2, Laxmi Supriya Yarrabathinac,e,4, Greeshma Rangarid,5, Navya Sree Keshetty d,6\u003Cbr>a Senior Resident Government General Hospital, Nizamabad, India b Rangaraya Medical College, Kakinada, Andhra Pradesh, India c Squad Medicine and Research (SMR), Amadalavalasa, India d Government Medical College, Nizamabad, India\u003Cbr>e Gandhi Medical College, Secunderabad, India |  |  |\n| --- | --- | --- |\n| A R T I C L E I N F O |  | A B S T R A C T |\n| Keywords:\u003Cbr>Unilateral buttock pain Post-partum Sacroiliac joint Brucellosis\u003Cbr>Brucella Melitensis |  | Brucellosis is one of the most common zoonotic diseases, presenting with a wide range of clinical manifestations. The most common symptoms include undulating fever and musculoskeletal issues. Frequent complications tend to involve osteoarticular surfaces, leading to spondylitis, osteomyelitis, and peripheral arthritis. Septic arthritis is another serious complication, the early diagnosis of which can be challenging, especially in the postpartum period, as the symptoms are often non-specific and easily misinterpreted. A 21-year-old female presented to our clinic in the fourth week of her postpartum period with severe unilateral buttock pain. She was sub febrile and had no apparent abnormalities on a pelvic X-ray. The pain was intense to the point that she could not walk properly. Sacroiliac MRI during the acute pain episode revealed mild bilateral sacroiliac (SI) joint effusion, predominantly on the right side, with bone marrow edema in the sacral and iliac aspects of the right SI joint, accompanied by some articular erosions and adjacent myofascial edema. The patient tested seropositive for brucellosis and completely recovered with antibiotic therapy. The patient was under follow-up for 3 months and she underwent a significant remission in symptoms with her pain substantially reduced. Brucella sacroiliitis should be considered in postpartum patients presenting with unilateral buttock pain that is unresponsive to analgesics and associated with difficulty walking. |\n\nIntroduction  \nBrucellosis is associated with occupational and domestic exposure to infected animals or their products. Farmers, shepherds, veterinarians, and slaughterhouses are at high risk [1]. The incubation period is 1–2 months, and up to one-third of patients present with musculoskeletal system involvement and symptoms such as pain and fever. Osteomyelitisis more common in lumbar and lower thoracic vertebrae. Osteomyelitis commonly affects the lumbar and lower thoracic vertebrae, while septic  \narthritis frequently involves large joints, including the knee, hip, sacroiliac, and shoulder [3].  \nBrucellosis is a bacterial zoonotic infection transmitted to humans either directly or indirectly from infected animals, predominantly from domesticated ruminants such as sheep, goats, camels, and swine, through contact or consumption of contaminated products, especially unpasteurized milk and dairy [1]. It is commonly referred to as \"undulant fever\" due to its remittent nature. Brucella melitensis is the most frequent cause of human brucellosis, with sheep, goats, and camels as  \n* Correspondence to: SMR Main Office, Squad Medicine and Research (SMR), Amadalavalasa, Andhra Pradesh, India.  \nE-mail addresses: [pavansailagishetty@gmail.com](pavansailagishetty@gmail.com) (S.P. lagishetty), [drtarunsuvvariresearch@gmail.com](drtarunsuvvariresearch@gmail.com) (T.K. Suvvari), [ridhinalam@gmail.com](ridhinalam@gmail.com) (R. Nalam),  \n[laxmisupriya628@gmail.com](laxmisupriya628@gmail.com) (L.S. Yarrabathina), [greeshmar","cbCaikv5qg9nYNAJ","https://ap.wps.com/l/cbCaikv5qg9nYNAJ","pdf",1012993,"English","# Introduction\n## Case report\n## Imaging findings\n## Serological confirmation and treatment\n## Follow-up and outcome","[{\"question\":\"Why is septic arthritis difficult to diagnose in postpartum patients?\",\"answer\":\"Postpartum presentations are often non-specific, and symptoms can be easily misinterpreted, which makes early diagnosis challenging.\"},{\"question\":\"What did pelvic MRI show during the acute pain episode?\",\"answer\":\"MRI revealed mild bilateral sacroiliac joint effusion, predominantly on the right, with bone marrow edema in the right sacral and iliac aspects, plus articular erosions and adjacent myofascial edema.\"},{\"question\":\"How was the patient treated and what was the outcome?\",\"answer\":\"Serology confirmed brucellosis, and the patient completely recovered with antibiotic therapy, with significant symptom remission during a 3-month follow-up.\"}]","Unilateral septic sacroiliitis caused by Brucella Melitensis in the postpartum period - A rare case report | PDF",1790565528]