Case Of Psoas Abscess Research Articles

A Rare Complication of Atypical Pancreatic Pseudocysts: A Case of Psoas Abscess with Renal Abscess

A Rare Complication of Atypical Pancreatic Pseudocysts: A Case of Psoas Abscess with Renal Abscess

A Case of Psoas Abscess Predicted by Urinary Tract Infection

A Case of Psoas Abscess Predicted by Urinary Tract Infection

A Case of Psoas Abscess Caused byStaphylococcus lugdunensis

Staphylococcus lugdunensis is a member of coagulase-negative staphylococci (CoNS), an uncommon microbial culture isolate with virulent potency. Although CoNS are common skin commensals, and often regarded as contaminants or colonizers when isolated from clinical specimen cultures, the clinical course and microbiological characteristics of Staphylococcus lugdunensis may resemble those of Staphylococcus aureus rather than other CoNS. Invasive infectious diseases such as infective endocarditis, peritonitis, skin and soft tissue infection, vascular prosthetic infection, septicemia, and osteomyelitis have been found to be associated with Staphylococcus lugdunensis. Here we report the first case of psoas abscess caused by methicillin-sensitive Staphylococcus lugdunensis in Korea. (Korean J Med 2014;86:367-371)

An Update on Psoas Muscle Abscess: An 8-Year Experience and Review of Literature

Psoas muscle abscess is a previously rare disease that has increased in its reported prevalence because of improved diagnostic tools. The literature on psoas muscle abscess mostly consists of case reports and case series. We analyzed medical records, such as characteristics, pathogens, and disease pattern, from our hospital in the past 8 years and report nine cases of psoas abscess. We also reviewed the literature for case series and performed a meta-analysis to assess the current characteristics of this disease since 1986. We reviewed a total of 36 studies, with a total of 682 cases. The average age was 52.6 years, and the mortality rate was 8% (55 of 682). In 35 studies, a total of 274 cases (40.77%) received drainage (274 of 672), whereas 290 (43.15%) received surgery. In 522 cases, the ratio of primary to secondary etiologies was 1:1.71. In 209 cases, Staphylococcus aureus, and in 70 cases, Escherichia coli were identified as the pathogens from culture data. Compared with Ricci’s case series, we found an obvious increase in prevalence of secondary causes (63.2% compared with 21.8%) and higher mortality in recent study (6.7% in Ricci’s study and 8.1% in recent study). There was an obvious shift toward drainage as the treatment of choice. We conclude that a higher mortality has occurred in recent study, and psoas abscess is an infrequent and easily overlooked infectious disease requiring early diagnosis with favorable results with percutaneous drainage.

Tuberculous psoas abscess in obstetrics

We read with interest the article by Kumar et al. [1] regarding psoas abscess in obstetrics. Although rare, psoas abscess have been reported during pregnancy. Their subtle symptomatology evades detection clinically. We will like to share our experience of a case of psoas abscess diagnosed during an exploratory laparotomy for ruptured ectopic pregnancy. A para 1, 22-year-old woman presented with 2 months of amenorrhea and pain in abdomen. The pain had worsened in past 3 days and was now associated with vomiting and giddiness. Patient had severe palor, tachycardia and hypotension. On palpation of abdomen, Wndings were a Wxed dull to percussion mass felt in left lumbar region with mild tenderness and rigidity in right iliac fossa. Digital vaginal examination revealed an anteverted normal size uterus associated with cervical motion tenderness and a cystic mass about 4 £ 5 cm was palpable in right fornix extending to pouch of Douglas. The left lumbar abdominal mass was also tipped through left fornix. Blood chemistry revealed hemoglobin of 6 g%. Complete blood count, liver and kidney functions were normal. Urine pregnancy test was positive. On ultrasound evaluation, right adnexa revealed a ruptured ectopic gestational sac with Xuid in pouch of Douglas. Uterus was normal in size and endometrial cavity was empty. Left ovary was normally visualized. The left abdominal mass was suspected to be a psoas abscess extending into the hemipelvis. It was cystic with thick wall and few septations. Patient was taken for urgent laparotomy and right-sided salpingectomy for ruptured ectopic pregnancy. The left retroperitoneal cystic Xuctuant swelling measured approximately 10 £ 15 cm. It was suspected to be tuberculous psoas abscess in view of straw colored Xuid obtained on aspiration peroperatively. Fluid cytology revealed exudative nature with predominance of lymphocytes. The Gram stain and aerobic culture revealed no organisms. The aspirated Xuid investigated by PCR (polymerase chain reaction) tested positive for Mycobacterium. The radiographs of the spine, pelvis with both hips were normal. Computed tomography (CT) of spine and abdomen other than presence of left psoas abscess was also normal. The abscess was drained percutaneously under CT (Fig. 1) guidance postoperatively under cover of multidrug antitubercular chemotherapy. Serial ultrasound has shown remarkable response to the therapy. Psoas abscess is a rare manifestation in pregnancy. Only four cases of psoas abscess diagnosed during ongoing pregnancy have been reported in indexed English literature till date (Table 1) [1, 2]. Other reported cases have either been postabortal or post partum [2–5]. Kumar et al. describes the only other case of tubercular psoas abscess detected during pregnancy [1]. Our case is the Wrst report of psoas abscess diagnosed with ectopic pregnancy. Patient gave no history of previous tuberculosis or exposure on retrospective questioning. The psoas abscess seemed tubercular in view of straw colored Xuid obtained on aspiration peroperatively. There was a risk of tubercular Xare-up with the contamination of abdominal cavity. The percutaneous drainage under CT guidance was done under cover of antitubercular drugs a few weeks later. Wherever possible, percutaneous drainage is the preferred method of abscess drainage as it is much less invasive than open surgical technique. It is technically demanding and requires help of a trained radiologist. R. Agarwal · A. Suneja · S. Raina Department of Obstetrics and Gynaecology, University College of Medical Sciences, Guru Teg Bahadur Hospital, Shahdara, Delhi, India

Primary brucellar psoas abscess: presentation of a rare case of psoas abscess caused by Brucella melitensis without any osteoarticular involvement

The psoas abscess is an entity, sometimes forgotten in our daily practice, because of infrequency and difficulties in diagnosis. Primary psoas abscess is very rare and gram-positive micro-organisms account for more than 80% of the cases. Our case, a 62-year-old man was admitted with a 5-year history of back pain and fever. Physical examination was normal, except a palpable hepatomegaly with a mild tenderness over his lower right abdominal quadrant. The Brucella agglutination test was strongly positive with a titre of 1/640, as Rose Bengal Spot test. Blood cultures for brucella were positive on the fourth day and became negative, as the specific therapy started. Further examination with ultrasonography and computed tomography revealed an abscess of 40 + 75 mm in the psoas muscle. Complete resolution of symptoms achieved within 6 weeks. Although clinical presentation of psoas abscesses is often similar and non-specific, early aetiological diagnosis is extremely important, because of high achievement with appropriate antibiotic regimens. Brucellar psoas abscess seems very rare even in Turkey, where Brucella is still highly endemic. Such a case has not been previously reported from Turkey, as far as we know.

A Case of Psoas Abscess Caused by Remnant Appendix

A Case of Psoas Abscess Caused by Remnant Appendix

Psoas Abscess: a Rare Complication of Crohn’s Disease

Psoas abscess is a rare complication of Crohn’s disease.Methods and materials: We evaluated the incidence of psoas abscess on 312 patients with Crohn’s disease, seen at our institution between 1992-2001.Results: We encountered three cases of psoas abscess (0.9%). One patient was managed with ileocolic resection and immediate anastomosis, while in two patients a percutaneous drainage was first performed and then, after 12 days of total parenteral nutrition, a resection of the diseased bowel with immediate reconstruction was carried out. Conclusions: A correction of the nutritional deficiencies is mandatory. Percutaneous computed-tomography guided drainage of the abscess with intestinal resection with immediate anastomosis, performed after a parenteral hyperalimentation, should be the method of choice in the management of such patients.

Low Back Pain: Would it be Psoas Abscess?

Psoas abscess is an uncommon clinical entity. It can be a primary infection with no obvious source of infection or a secondary infection from other sites, e.g. gastrointestinal tract or spinal pathology. The triads of presentation: fever, loin pain and limitation of hip movement may not be found in all patients. The correct diagnosis can be made with a vigilant clinical examination and appropriate investigation, for example ultrasonography. We present two cases of psoas abscess. One was a primary case and the other was secondary to carcinoma of caecum. Both of them presented with recent onset of back pain. Emergency physicians consider psoas abscess as one of the differential diagnosis for patient complaining of low back pain.

クローン病に腸腰筋膿ようが合併した１例

クローン病に腸腰筋膿ようが合併した１例

エコー下経皮的ドレナージによる腸腰筋膿ようの治療経験

We treated three cases of psoas abscess by echo-guided percutaneous drainage of the abcess. These patients recovered well. Echo-guided percutaneous drainage combined with appropriate antibiotic therapy is the first choice procedure for treatment of a psoas abscess if the patient's condition is poor.

腸腰筋膿ようの治療経験

We report on the treatment of five cases of psoas abscess. The age distribution ranged from 53 to 66 years with an average age of 60 years. Diagnosis of psoas abscess was easily recognized by computed tomography. All cases were treated with antibiotics, open surgical drainage was added for two cases and another two cases also received Echo-guided percutaneous catheter drainage. We achieved successful results in all cases. The Echo-guided percutaneous catheter drainage was performed under local anesthesia with minimum surgical damage. Our experience suggests that, in most cases of psoas abscess, percutaneous catheter drainage will be successful and should now be considered the treatment of choice.

Psoas abscess: drainage through Petit's triangle

Thirteen cases of psoas abscess were treated by surgical drainage through Petit's triangle. This underutilized anatomic space provides a simple and effective route for drainage of retroperitoneal abscesses.

高浸透圧性非ケトン性糖尿病昏睡を来した腎う癌による腸腰筋膿ようの一例

A 85-year-old man was admitted to our hospital because of semicomatous status. Laboratory data on admission showed elevation of blood sugar (823 mg/dl) and serum osmotic pressure (345 mOsm/l), but ketonuria was not detected. Non-ketotic hyperosmolar diabetic coma was diagnosed. The insulin infusion and physiological saline improved the blood sugar level and consciousness within a day. The abdominal ultrasound examination revealed an abscess in the left kidney and right psoas muscle. The same findings were seen by abdominal computed tomography but the possibility of malignant neoplasm of the left kidney could not be ruled out because of a swelling of the left adrenal gland. Pain associated with psoas abscess and low grade fever were observed. Because of his poor general condition, drainage of the abscess was not performed and conservative therapy using antibiotics was administered. Without any improvement of the abscess, he died due to general deterioration four months later. Autopsy findings showed carcinoma of the left renal pelvis and metastasis to the right psoas muscle, left adrenal gland, liver, bilateral lungs and lymph modes. Psoas abscess is a relatively uncommon disease, especially in elderly patients. The etiology of the disease is divided into primary and secondary causes. Most secondary psoas abscess cases are caused by intestinal diseases, and Crohn's disease has been related to the highest incidence. A few cases of psoas abscess caused by colorectal carcinoma have been reported. Ultrasound and computed tomography are useful in diagnosing this disease and drainage of an abscess is necessary for therapy and proving the cause. Cancer metastasis should considered in differential diagnoses, when psoas abscess is seen in elderly patients.

Psoas abscess simulating clostridial infection

Two cases of psoas abscess have been presented which were caused by anaerobic Streptococci, both of which originated in a pathologic condition in the descending colon. Both patients with simulated gas gangrene infections had originally presented themselves with vague complaints referrable to the thigh and knee. It is suggested that other organisms be considered along with the clostridial bacillus when gas is found in the soft tissues of an infected area. It is further suggested that the possibility of psoas abscess should be entertained in patients who present themselves with pain in the knee and hip, especially if they are known to have pathologic conditions in the abdomen.

Report of a Case of Psoas Abscess Resulting from Tuberculosis of the Cervical Spine

Report of a Case of Psoas Abscess Resulting from Tuberculosis of the Cervical Spine