Discitis Caused by Acute Pelvic Inflammatory Disease：A Case Report and Literature Review

Background: Pelvic inflammatory disease (PID), a common gynecological infection, includes endometritis, tubo-ovarian abscess, and pelvic peritonitis ^[1] . Uterine operations like abortion or intrauterine Device (IUD) removal may induce pelvic infection, causing lumbago, abdominal pain, menstrual disorders, or even systemic infection. Post-abortion pelvic infection incidence is 5.88%-8.79% ^[2-3] .This case report describes a patient who developed acute PID following a difficult IUD removal procedure, ultimately progressing to rare discitis with restricted lumbar mobility. While PID represents a common gynecological condition, its complication of secondary discitis causing significant motor impairment has been scarcely documented in medical literature. Through comprehensive imaging studies and pathogenetic analyses, this case confirmed the pathogenic spread of infection across anatomical boundaries. It highlights the critical need for prompt management of pelvic infections to prevent their potentially severe transcompartmental dissemination. This report serves to alert obstetric and gynecological practitioners about PID's underrecognized complications while emphasizing the importance of enhanced diagnostic vigilance and preventive strategies. Case presentation: A 44-year-old female underwent difficult IUD removal lasting nearly 2 hours, developing septic shock postoperatively. After antibiotic treatment, she had residual lumbosacral pain and left lower limb convulsive pain. Transferred to our hospital, she was diagnosed with discitis via examinations and multidisciplinary collaboration. Laparoscopic exploration was performed promptly, with full recovery and symptom resolution. Conclusion: By analyzing this case and literature, we explore antibiotic selection, surgical timing and methods, summarizing lessons to improve clinicians' understanding of PID and discitis, aiding standardized diagnosis, treatment, and related research.