{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T06:11:49Z","timestamp":1761027109740,"version":"build-2065373602"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81972511"],"award-info":[{"award-number":["81972511"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Guangdong Provincial Medical Science and Technology Research Foundation","award":["B2023296"],"award-info":[{"award-number":["B2023296"]}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the clinical characteristics of pubic symphysis infection and evaluate the safety and efficacy of vancomycin-loaded calcium sulfate (VCS) artificial bone combined with debridement in treating these infections in adolescents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analyzed a clinical case and supplemented our findings with a narrative literature review. The evaluation focused on a 13-year-old female patient diagnosed and treated at our hospital in February 2025. To contextualize our case, we searched PubMed, Wanfang, China National Knowledge Infrastructure (CNKI), VIP, and China Biology Medicine (CBM) databases for articles available from the establishment of each database up to April 2023. Data from the present case and previously documented cases of pubic symphysis infection in pediatric patients who met the inclusion criteria were compiled. The data, with a particular focus on clinical presentations, treatment modalities, and follow-up outcomes, were analyzed to draw comparative insights regarding treatment efficacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A comprehensive literature review identified eight documented pediatric cases of pubic symphysis infection, each presented as individual case reports. Notably, one of these cases lacked identifiable risk factors. All patients were effectively managed through conventional surgical d\u00e9bridement in conjunction with antibiotic therapy. In the current case, the patient underwent a two-stage intervention that included the implantation of vancomycin-loaded calcium sulfate (VCS) beads, d\u00e9bridement of the pubic symphysis, and bilateral pubic fenestration and drainage. This was succeeded by a six-week regimen of postoperative antibiotic therapy. The patient exhibited an excellent recovery, characterized by normalized bilateral hip range of motion and absence of tenderness over the pubic symphysis. Follow-up imaging revealed the resorption of the VCS beads and bilateral callus formation. Unlike previously reported cases, the treatment strategy implemented in this instance obviated the necessity for repeated d\u00e9bridement and dressing changes, thereby significantly reducing patient discomfort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The application of VCS combined with debridement was effective in controlling infection and promoting bone regeneration in this pediatric case, offering a promising therapeutic approach for similar rare infections.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2025.1619126","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T05:36:28Z","timestamp":1761024988000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment of pubic symphysis infection with vancomycin-loaded calcium sulfate artificial bone combined with debridement in pediatric patients: a case report and literature review"],"prefix":"10.3389","volume":"12","author":[{"given":"Su","family":"De-zhi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wu","family":"Gang-quan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ye","family":"Shi-min","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wang","family":"Kun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu","family":"Ying-chou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhai","family":"Guo-min","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhu","family":"Zhe-min","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Yi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhuo","family":"Bao-biao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"149","DOI":"10.11604\/pamj.2014.18.149.4421","article-title":"Septic arthritis of the pubic symphysis: a case report","volume":"18","author":"El Mezouar","year":"2014","journal-title":"Pan Afr Med J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"952","DOI":"10.1186\/s12879-019-4595-x","article-title":"Osteomyelitis of the pubic symphysis caused by methicillin-resistant Staphylococcus aureus after vaginal delivery: a case report and literature review","volume":"19","author":"Cosma","year":"2019","journal-title":"BMC Infect Dis"},{"key":"B3","first-page":"421","article-title":"Septic arthritis of the pubic symphysis","volume":"7","author":"Nitsche","year":"1989","journal-title":"Clin Exp Rheumatol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1097\/00006454-200009000-00021","article-title":"Prevesical abscess secondary to pubis symphysis septic arthritis","volume":"19","author":"Lorenzo","year":"2000","journal-title":"Pediatr Infect Dis J"},{"key":"B5","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1097\/PEC.0b013e3181a34968","article-title":"Septic arthritis of the pubic symphysis in an 11-year-old boy","volume":"25","author":"Hartshorn","year":"2009","journal-title":"Pediatr Emerg Care"},{"key":"B6","doi-asserted-by":"publisher","first-page":"666","DOI":"10.1016\/j.jfma.2012.08.007","article-title":"Septic arthritis of the pubic symphysis in an 8-year-old boy","volume":"113","author":"Tsai","year":"2014","journal-title":"J Formos Med Assoc"},{"key":"B7","doi-asserted-by":"publisher","first-page":"982171","DOI":"10.1155\/2014\/982171","article-title":"Symphysis pubis osteomyelitis with bilateral adductor muscles abscess","volume":"2014","author":"Alqahtani","year":"2014","journal-title":"Case Rep Orthop"},{"key":"B8","doi-asserted-by":"publisher","first-page":"6384707","DOI":"10.1155\/2016\/6384707","article-title":"Spontaneous septic arthritis of pubic symphysis in an elite athlete","volume":"2016","author":"Smits","year":"2016","journal-title":"Case Rep Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"8819268","DOI":"10.1155\/2020\/8819268","article-title":"Relapsed symptoms in a patient treated for pubic symphysis septic arthritis\/adjacent osteomyelitis: diagnostic challenges","volume":"2020","author":"Upadhyayula","year":"2020","journal-title":"Case Rep Infect Dis"},{"key":"B10","doi-asserted-by":"publisher","first-page":"10.2106\/JBJS.CC.23.00475","DOI":"10.2106\/JBJS.CC.23.00475","article-title":"Septic arthritis of the pubic symphysis in a 16-year-old male adolescent: a case report","volume":"13","author":"Kim","year":"2023","journal-title":"JBJS Case Connect"},{"key":"B11","doi-asserted-by":"publisher","first-page":"98","DOI":"10.4103\/ijmy.ijmy_16_21","article-title":"Pubic symphysis tuberculosis: a diagnostic dilemma","volume":"10","author":"Ahammadunny","year":"2021","journal-title":"Int J Mycobacteriol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1016\/j.urology.2020.07.038","article-title":"Urinary pubic symphysis Fistula leads to histopathologic osteomyelitis in prostate cancer survivors","volume":"148","author":"Kahokehr","year":"2021","journal-title":"Urology"},{"key":"B13","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1016\/j.urology.2016.08.035","article-title":"Pubic bone resection provides objective pain control in the prostate cancer survivor with pubic bone osteomyelitis with an associated urinary tract to pubic symphysis Fistula","volume":"100","author":"Lavien","year":"2017","journal-title":"Urology"},{"key":"B14","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1016\/j.urology.2021.10.019","article-title":"Robotic puboprostatic Fistula repair with holmium laser pubic debridement","volume":"160","author":"Hebert","year":"2022","journal-title":"Urology"},{"key":"B15","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1136\/bjsm.2008.050989","article-title":"Treatment of osteitis pubis and osteomyelitis of the pubic symphysis in athletes: a systematic review","volume":"45","author":"Choi","year":"2011","journal-title":"Br J Sports Med"},{"key":"B16","doi-asserted-by":"publisher","first-page":"687","DOI":"10.3390\/ph16050687","article-title":"Collaterally sensitive \u03b2-lactam drugs as an effective therapy against the pre-existing methicillin resistant staphylococcus aureus (MRSA) biofilms","volume":"16","author":"Hashmi","year":"2023","journal-title":"Pharmaceuticals"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1029261","DOI":"10.3389\/fmicb.2022.1029261","article-title":"Antimicrobial potency, prevention ability, and killing efficacy of daptomycin-loaded versus vancomycin-loaded \u03b2-tricalcium phosphate\/calcium sulfate for methicillin-resistant Staphylococcus aureus biofilms","volume":"13","author":"Zhang","year":"2022","journal-title":"Front Microbiol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1537","DOI":"10.1302\/0301-620X.99B11.BJJ-2017-0297.R1","article-title":"The levels of vancomycin in the blood and the wound after the local treatment of bone and soft-tissue infection with antibiotic-loaded calcium sulphate as carrier material","author":"Wahl","year":"2017","journal-title":"Bone Joint J"},{"key":"B19","doi-asserted-by":"publisher","first-page":"42","DOI":"10.5312\/wjo.v14.i2.42","article-title":"Diagnosis and treatment of chronic osteomyelitis based on nanomaterials","volume":"14","author":"Zeng","year":"2023","journal-title":"World J Orthop"},{"key":"B20","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1186\/s13018-018-0922-y","article-title":"Clinical experience of debridement combined with resorbable bone graft substitute mixed with antibiotic in the treatment for infants with osteomyelitis","volume":"13","author":"Zhang","year":"2018","journal-title":"J Orthop Surg Res"},{"key":"B21","doi-asserted-by":"publisher","first-page":"61","DOI":"10.5194\/jbji-7-61-2022","article-title":"Short and oral antimicrobial therapy for diabetic foot infection: a narrative review of current knowledge","volume":"7","author":"Maurer","year":"2022","journal-title":"J Bone Jt Infect"},{"key":"B22","doi-asserted-by":"publisher","first-page":"944","DOI":"10.3390\/antibiotics12060944","article-title":"Systemic antimicrobial treatment of chronic osteomyelitis in adults: a narrative review","volume":"12","author":"Be\u0161al","year":"2023","journal-title":"Antibiotics"},{"key":"B23","doi-asserted-by":"publisher","first-page":"4631","DOI":"10.1007\/s00586-025-08993-9","article-title":"Clinical outcomes, safety, and cost considerations of rhBMP-2 in the surgical management of pyogenic spinal infections: a focused review","volume":"34","author":"Mahfouz","year":"2025","journal-title":"Eur Spine J"},{"key":"B24","doi-asserted-by":"publisher","first-page":"2576","DOI":"10.1038\/s41598-025-86013-y","article-title":"Prevalence and predictors of infected diabetic foot ulcers (DFU) and DFU-related osteomyelitis amongst industrial workers wearing occupational safety footwear","volume":"15","author":"Mondal","year":"2025","journal-title":"Sci Rep"},{"key":"B25","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1002\/2211-5463.12809","article-title":"A dual PMMA\/calcium sulfate carrier of vancomycin is more effective than PMMA-vancomycin at inhibiting Staphylococcus aureus growth in vitro","volume":"10","author":"Luo","year":"2020","journal-title":"FEBS Open Bio"},{"key":"B26","doi-asserted-by":"publisher","first-page":"e947099","DOI":"10.12659\/AJCR.947099","article-title":"Innovative management of Brodie\u2019s abscess: continuous local antibiotic perfusion in a 14-year-old patient","volume":"26","author":"Sawauchi","year":"2025","journal-title":"Am J Case Rep"},{"key":"B27","doi-asserted-by":"publisher","first-page":"e37858","DOI":"10.1002\/jbm.a.37858","article-title":"Investigation of antibiotic-releasing biodegradable composite bone cements for treating experimental chronic maxillofacial bone infection","volume":"113","author":"Mistry","year":"2025","journal-title":"J Biomed Mater Res A"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1619126\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T05:36:30Z","timestamp":1761024990000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1619126\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,21]]},"references-count":27,"alternative-id":["10.3389\/fsurg.2025.1619126"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2025.1619126","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,21]]},"article-number":"1619126"}}