E-Posters-Pelvic Anatomy as Related to a Deep Soft Tissue Infection After Trigger Point Injection

Pelvic Anatomy as Related to a Deep Soft Tissue Infection After Trigger Point Injection - Julia Shinnick, MD

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This article discusses a case of a severe pelvic soft tissue infection following trigger point injections for myofascial pelvic pain. Trigger point injections are commonly used for the management of musculoskeletal pelvic pain, but the accuracy of the injections is not well evaluated. Complications from these injections are rare, and pelvic infections are rarely described. However, this case highlights the importance of considering infection as a potential complication.<br /><br />The case involves a 28-year-old female with myofascial pelvic pain who received trigger point injections bilaterally in several muscles. Eight days after the injections, the patient developed fevers, chills, fatigue, and gluteal erythema. Despite oral antibiotics, her symptoms worsened and a CT scan revealed a pelvic soft tissue infection with extensions into the gluteal, perivulvar, and perianal regions. Cultures grew E. coli and the patient underwent incision and drainage and was treated with intravenous antibiotics.<br /><br />The article suggests that in higher-risk patients, antibiotic prophylaxis or injection under ultrasound guidance may be considered to reduce the risk of infection. It also discusses the potential factors that may have contributed to the development of the infection, such as the trajectory of the needle and the placement of injections into the ischiorectal fossa.<br /><br />The case highlights the importance of considering infection as a potential complication of trigger point injections and emphasizes the need for further research on the accuracy and safety of these injections. It also notes that daily corticosteroid use may increase the risk of infection.<br /><br />In conclusion, this case report underscores the need for caution when performing trigger point injections for pelvic pain and highlights the importance of considering infection as a potential complication. Further research is warranted to better understand the accuracy and safety of these injections.

Keywords

pelvic soft tissue infection

trigger point injections

myofascial pelvic pain

musculoskeletal pelvic pain

complications

infection

antibiotic prophylaxis

ultrasound guidance

needle trajectory

ischiorectal fossa