Bilateral Psoas Abscesses Research Articles

Bilateral tuberculosis psoas abscess in a human immunodeficiency virus-positive patient: a case report

BackgroundWorldwide, there is an increase in the frequency of reports of psoas abscesses due to advances in imaging technology, which has led to early diagnosis and treatment. A bilateral psoas abscess is rare and, when it occurs, is usually secondary and in immunocompromised patients. We present a case of a bilateral tuberculosis psoas abscess in a human immunodeficiency virus-positive patient.Case presentationA 21-year-old Ugandan female undergraduate who contracted human immunodeficiency virus through vertical transmission and has been on highly active antiretroviral drugs presented with bilateral lower abdominal pain with associated fever and headache. Clinical examination revealed abdominal tenderness in both iliac fossae with palpable masses. Ultrasonography revealed fluid collection in both psoas muscles confirming bilateral abscesses. The aspirate was acid-fast bacilli positive. A diagnosis of bilateral tuberculosis psoas abscess was made. Open drainage was performed and antituberculosis drugs were commenced.ConclusionsBilateral tuberculosis psoas abscesses occurring in human immunodeficiency virus-positive patients, although uncommon, is not unexpected. It is a form of secondary psoas abscess in immunocompromised patients. Here, the outcome was successful with a combination of early surgical drainage and appropriate medical therapy.

Bilateral Psoas Abscess Extended into Spinal Canal in a Patient with Long-Standing Poorly Controlled Diabetes Mellitus – A Case Report

Bilateral Psoas Abscess Extended into Spinal Canal in a Patient with Long-Standing Poorly Controlled Diabetes Mellitus – A Case Report

Bilateral PSOAS Abscess - One of the Largest of its Kind - Case Report

Bilateral PSOAS Abscess - One of the Largest of its Kind - Case Report

Disseminated MAI in an HIV Patient-An Unusual Presentation

Patients with Human Immunodeficiency Virus (HIV), and especially Acquired Immunodeficiency Syndrome (AIDS), can present in a multitude of ways with a variety of possible pathologies. This can prove to be a challenge to a clinician. The patient, in this case, was found to have disseminated Mycobacterium-avium-intracellulare (MAI), despite compliance with antiretroviral therapy (ART), who presented with right upper quadrant pain, isolated elevated alkaline phosphatase, and sepsis. Imaging revealed multiple splenic lesions, bilateral psoas abscesses, abdominal lymphadenopathy, and a large right pleural effusion with a mediastinal shift to the left. Psoas abscesses were drained and the cultures grew acid-fast bacilli. The patient was treated with azithromycin, ethambutol and rifabutin. Classically, MAI infections of patients compliant with ART therapy present with localized disease. This case offers a different presentation of MAI despite compliance with ART therapy.

A rare presentation of blastomycosis as a multi-focal infection involving the spine, pleura, lungs, and psoas muscles in a Saudi male patient: a case report

BackgroundBlastomycosis is a disease caused by the fungus Blastomyces—a thermally dimorphic fungus that can cause granulomatous and/or purulent infection.Case presentationWe report here a case of chronic blastomycosis infection in a 24-year-old male patient from Saudi Arabia who presented with recurrent skin abscesses associated with deep-seated and multilevel paraspinal (dorsal and lumbar) collections and bilateral empyema with pulmonary involvement and bilateral psoas abscesses. The diagnosis was made after a CT-guided pleural biopsy revealed the characteristic histopathological findings of blastomycosis. The patient underwent several drainage procedures and was successfully treated with a long-term course of oral itraconazole.ConclusionsChronic blastomycosis may have clinical and radiologic features similar to thoracic tuberculosis or malignant disease. There is no definite clinical symptom of blastomycosis, and thus a high degree of suspicion is required for early diagnosis. This case is a rare form of blastomycosis with chronic multifocal purulent infection and is the second case of blastomycosis reported in Saudi Arabia.

A Case of Tuberculous Spondylitis in Child with Undernourish

Tuberculous spondylitis accounts for around 2% of all cases of Tuberculosis (TB) and around 15% of extrapulmonary TB cases. It has been reported that a 17 years old boy with a complaint of a bump on the lumbar region and felt low back pain since two years before admission with a history of back trauma. There was a decrease of body weight. There was no paraesthesia nor paralysis. Defecation and micturition were normal. Basic immunization was incomplete. On physical examination found palpable lymph nodes 0,5x0,5x0,5 cm, multiple et regio colli. There was no BCG scar. Impression nutritional status was undernourished. There was fixed palpable mass at back size about 5x4x5 cm, hard, no fluctuations, no rebound tenderness. Lung examination was normal. Tuberculin test showed induration sized 20 mm. Gene Xpert result Micobacterium Tuberculosis (MTB) not detected. On chest X-ray examination found L1-2 corpus destruction. MRI Spine was suggestive of compressive fractures and suggestive of a bilateral psoas abscess. Decompression and lumbar stabilization surgery were performed. The histopathology examination results were consistent to spondylitis TB characteristics. The patient was discharged on 6th hospitalization and given anti-tuberculous drug.Keywords: bump, extrapulmonary, fracture, spondylitis, tuberculosis

Perforated sigmoid diverticulitis masquerading as multiple intra and extra abdominal disseminated abscesses

Abscess formation in perforated diverticulitis is most commonly confined to the pelvis, with other intraperitoneal and extraperitoneal locations rarer in the literature. Presented here is the case of a 63-year-old male who was diagnosed with perforated diverticulitis which manifested in multiple intra- and extra-abdominal abscesses. These were identified on abdominopelvic computed tomography to include a presacral abscess, bilateral psoas abscesses, a large left flank abscess located between the internal and external oblique muscles, as well as osteomyelitis of the S1 vertebra. To the best of the authors’ knowledge, this is the first reported case in the literature with this disseminated constellation of abscesses secondary to acute perforated diverticulitis.

A Rare Case of Vertebral Osteomyelitis and Bilateral Psoas Abscess From an Unknown Source

We present a case of a 31-year-old Filipino man with vertebral osteomyelitis and bilateral psoas abscesses. Vertebral osteomyelitis is a rare infection of the bone and bone marrow that affects the vertebral column. The patient’s initial presentation included a 1-week history of cough, fatigue, diarrhea, fevers, and a 40-pound weight loss. An extensive workup including a computed tomography (CT) scan of the abdomen and pelvis demonstrated bilateral psoas abscesses with subcutaneous air tracking into the right flank. Blood cultures revealed Escherichia coli , Streptococcus anginosus , and Bacteroides . However, with an unclear primary source of infection, the most likely causative factor we believed to be due to immobility. J Med Cases. 2020;11(11):345-347 doi: https://doi.org/10.14740/jmc3565

Pott’s disease with extensive bilateral psoas abscesses in a Nigerian woman: an unusual case

Bilateral psoas abscesses are uncommon in Pott's disease. We describe a 28-year-old Nigerian woman with a 2-year history of constitutional symptoms and a 1-year history of bilateral paravertebral masses. She had received anti-tuberculosis (TB) treatment in an interrupted manner. A computed tomography (CT) scan revealed T10-T12 spondylitis, wedge collapse and extensive bilateral psoas abscesses. Histology of the abscess wall was definitively diagnosed as soft tissue TB, and special staining for acid-fast bacilli was positive. She was successfully treated with anti-TB therapy and ultrasound-guided surgical drainage of 6 L of abscess fluid. Complicated cases of Pott's disease may require multi-disciplinary interventions for optimal outcome.

Metastatic Pancreatic Cancer Masquerading as Bilateral Psoas Abscesses

Metastatic Pancreatic Cancer Masquerading as Bilateral Psoas Abscesses

Complicated Diverticulitis with Infective Spondylitis and Bilateral Psoas Abscesses: A Classic Case of Late Diagnosis

Complicated Diverticulitis with Infective Spondylitis and Bilateral Psoas Abscesses: A Classic Case of Late Diagnosis

Bilateral psoas abscess caused by Janibacter terrae, an unusual condition and organism resulting in laboratory and management conundrums

Psoas abscess is commonly regarded as an unusual cause for back pains and usually associated with significant risk factors or co-morbidities. We describe the clinical presentation and findings of a young male Caucasian with bilateral psoas abscesses caused by an unusual organism, Janibacter terrae (an environmental organism) not previously described in literature and the challenges faced in managing this infection. There are very few case reports of this organism causing opportunistic infections, all reported bacteraemia mainly in patients with significant co-morbidities. This case highlights the importance of psoas abscess as a differential diagnosis in patients presenting with back pain and the potential for this organism to cause abscesses in healthy individuals which was difficult to identify using conventional laboratory methods. Management of this infection was challenging and there is limited experience with antimicrobial treatment for this organism.

Fibrinolytics in loculated abscess cavities - A report of two cases.

The efficacy of fibrinolytic therapy in two loculated abscesses is being reported. First case had a postoperative mediastinal abscess in left paraspinal location and the second case had two bilateral tubercular psoas abscesses. Both cases were managed with pig tail catheter drainage of abcesses and fibrinolytic therapy with instillation of urokinase followed by aspiration. Both cases had significant drainage, clinical and radiological resolution. There were no adverse effects in either case.

Complete Bilateral Calcified Psoas Abscess- Rare Sequelae of Untreated Pott’s Spine

Although rare in the western world; psoas abscess is a frequent finding in Indian sub continent associated with Pott's spine. Untreated Pott's spine may lead to various sequelae like destruction of vertebra, kyphosis, paraplageia etc which in modern world is amenable to anti-tubercular drugs and surgical management. We report a case of untreated Pott's spine with bilateral calcified psoas abscess with kyphosis. To the best of our knowledge no such case of complete bilateral calcified psoas abscesses has been reported earlier. We want to discuss this case with relevant literature review and its influence on treatment plan.

A Case of Type 2 Diabetes Complicated by a Series of Bilateral Psoas Abscesses in an Elderly Patient

A Case of Type 2 Diabetes Complicated by a Series of Bilateral Psoas Abscesses in an Elderly Patient

Surgical treatment for spinal tuberculosis with bilateral paraspinal abscess or bilateral psoas abscess: one-stage surgery.

This was a prospective study on the clinical outcomes of single-stage surgery for thoracic and lumbar spine tuberculosis patients with bilateral paraspinal or bilateral psoas abscesses. The aim of this study was to investigate the feasibility of, indications for, and clinical effects of single-stage posterior surgery for the treatment of thoracic and lumbar spinal tuberculosis with bilateral paraspinal or bilateral psoas abscesses. An increasing number of articles have been published on the use of single-stage surgery for spinal tuberculosis; however, none of these articles have discussed the use of such surgery in patients with bilateral abscesses. Between January 2003 and January 2011, 41 patients with thoracic and lumbar spinal tuberculosis and bilateral paraspinal or bilateral psoas abscesses were treated with single-stage posterior surgery. All of the patients were treated preoperatively with 1-2 weeks of antituberculosis drugs. All patients were managed postoperatively with standard courses of chemotherapy with triple or quadruple antituberculosis drugs. The clinical symptoms, complications, and laboratory and image indicators were recorded. There were no local recurrences except in one L3-L4 tuberculosis patient. Two patients presented with extraspinal tuberculosis in the third year. There were no incision complications. Bone fusion was observed 6 months after the operation. The erythrocyte sedimentation rate was normal at 3 weeks-3 months postoperatively. There were no internal fixation failures. The internal fixations in 6 young patients were removed after the spinal tuberculosis was cured. Single-stage posterior surgery with instrumentation results in less operative trauma and can be a suitable alternative for treating thoracic and lumbar tuberculosis with bilateral paraspinal or bilateral psoas abscesses.

Lemierre's disease: a case with bilateral iliopsoas abscesses and a literature review.

Lemierre’s disease is characterized by sepsis, often with an oropharyngeal source, secondary septic emboli and internal jugular vein thrombosis (Lancet 1:701–3, 1936. Clin Microbiol Rev 20(4):622–59, 2007). Septic emboli affecting many bodily sites have been reported, including the lungs, joints, bones, and brain. The case report describes an unusual case of Lemierre’s disease in a 64 year old gentleman causing profound sepsis, acute kidney injury, bilateral iliopsoas abscesses and a right hand abscess. To our knowledge, this is the first reported case of Lemierre’s disease in the context of bilateral psoas abscesses, and highlights the ambiguity surrounding the definition of Lemierre’s disease. The clinical literature review highlights the difficulty in definitively diagnosing the condition and offers some suggestions for recognising and refining the diagnostic criterion of Lemierre’s.

Spinal Epidural Abscess and Psoas Abscess Combined with Pyogenic Spondylodiscitis Following Vertebroplasty: A Case Report

Study Design: Case report. Objective: To report a case of extensive spinal epidural abscess and bilateral psoas abscesses combined with pyogenic spondylodiscitis after a L3 vertebroplasty. Summary of Literature Review: Infection after vertebroplasty or kyphoplasty is a rare medical complication. Few reports on spinal epidural abscess and bilateral psoas abscesses, coupled with pyogenic spondylodiscitis after vertebroplasty, are available in the English medical literature. Materials and Methods: The authors performed a clinical and radiographic case review. Results: A 74-year-old woman, without any existing medical illness, presented with a history of three weeks of lower back pain, fever, and neurologic deficits of both legs after vertebroplasty performed in another hospital. Magnetic resonance imaging demonstrated an extensive spinal epidural abscess from T10 to S1 and huge bilateral psoas abscesses combined with spondylodiscitis at L3-4. Urgent limited laminectomies and abscess drainage were performed from L1 to S1. The day after the operation, ultrasound-guided percutaneous drainage was performed to manage bilateral psoas abscesses. Methicillin-resistant Staphylococcus aureus was identified by intraoperative culture. Antibiotic therapy during hospitalization was maintained for six weeks with vancomycin and rifampicin. The infection was successfully treated without any neurologic deficit and spinal deformity. Conclusions: Vertebroplasty is relative safe and simple procedure; however, the procedure also may cause severe spinal infection. Aseptic techniques under sterile environment was required during surgery. It is important that early diagnosis and prompt surgical decompression in spinal epidural abscess with neurologic deficit. Limited surgery and antibiotic therapy could be a good treatment option in spinal epidural abscess combined with pyogenic spondylodiscitis.

Extensively-Drug Resistant Tuberculosis (XDR-TB) in Indian Children and Response to Treatment

We report two children aged 6 and 15 years respectively suffering from extensively-drug resistant tuberculosis (XDR-TB). The six year old was suffering from pulmonary TB and the 15 year old was suffering from TB spondylodiscitis with bilateral psoas abscesses. Both were treated with second-line antituberculous drugs (ATT) as per culture and drug susceptibility testing (DST) on tissue samples from the patients. Former child did not improved even after one and half years of treatment, while latter completed 2 years of ATT and had complete resolution of his psoas abscess.

Pott's Spine with Bilateral Psoas Abscesses

A high degree of suspicion and appropriate imaging studies are required for the early diagnosis of Pott's spine. We describe a 4-year-old boy with Pott's disease of the lumbar spine with bilateral psoas abscesses. The child responded to conservative treatment with antituberculous treatment and ultrasonographically guided percutaneous drainage of the abscesses.