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Meningitis caused by a psoas abscess. A case report.

An unusual case of a retroperitoneal abscess in a young woman, followed by an extremely rare complication, meningitis, and resulting in death is reported. The need for early diagnosis and prompt surgical treatment is emphasized. If this is carried out full recovery can be expected.

Abscess↗

[Primary abscess of the psoas. 2 new cases].

Since the antibiotherapy for tuberculosis, psoas abscess is an infrequent disease. The psoas abscess can be divided in primary and secondary, being the primary the most infrequent. We present two other cases of primary psoas abscess treated in our hospital. We review also the symptoms, the diagnosis and the therapy of this disease.

Abscess↗

[Pyogenic abscess of the psoas].

11 cases (7 primary and 4 secondary) of pyogenic psoas abscesses are reported. In all cases Staphylococcus aureus was isolated on blood culture or pus drained under ultra-sonographic control. US is very useful for diagnosis and the follow up of psoas pyogenic abscesses. Percutaneous aspiration and drainage of psoas abscesses under ultrasonographic control combined to antibiotherapy is an effective therapeutic procedure. Our experience suggests that antibiotherapy alone is an effective therapy of presuppurative pyogenic psoas abscesses and even in collected and non complicated primary psoas abscesses.

Abscess↗

[Primary pneumococcal abscess in the psoas muscle].

Primary psoas abscesses are rare and the pathogenesis is obscure. In most cases Staphylococcus aureus is the causative bacterium. Therapy consists of drainage of the abscess and antibiotics. In this article we present a patient with a primary psoas abscess caused by a Streptococcus pneumoniae infection.

Aged↗

[Primary abscess of the psoas. Report of a case].

Psoas abscess is an uncommon condition at the present time. The initial anodyne signs and symptoms make diagnosis difficult. It can be diagnosed and rated as primary when the origin is not found, or secondary when a focus for infection spreading is detected. Drainage either percutaneously or by open surgery, and antibiotic therapy are the choice treatment, achieving an important survival rate. This paper presents a new case of psoas abscess, including a revision of the diagnosis and treatment of this condition.

Adult↗

[Tubercular abscess of the psoas without associated spinal involvement. A case report].

INTRODUCTION: Tuberculous psoas abscess outside of locoregional causes is uncommon and can cause a problem of differential diagnosis. EXEGESIS: We report a case of unilateral tuberculous abscess of the psoas which first clinical and radiological features presented like a retroperitoneal tumor. Exploration laparotomy discovered a bulky abscess of the left psoas muscle. Bacteriologic and histologic evaluation confirmed the tuberculous origin. Radiological study of the spine did not show any signs of spondylodiscitis. Under antituberculosis treatment a crural collection occurred and a surgical drainage was performed. Five years later, there was a recurrence of a crural collection which responded well to antituberculosis treatment. CONCLUSION: Tuberculous psoas abscess is usually secondary to spinal involvement, more uncommonly to digestive, urologic or genital tuberculosis. Primary abscess was rarely described and the pathogenesis remains unclear. Psoas contamination is supposed to be hematogenous or lymphatic in origin. Ultrasonography and computed tomography (CT) transformed the diagnosis and the therapeutic approach by percutaneous puncture and drainage.

Adult↗

[Abscesses of psoas in diabetic patients: anatomo-clinical and therapeutical peculiarities].

Difficulties of diagnosis and of an adequate treatment of psoas muscle abscesses are increased by the evolution of the suppurative process in diabetic patients. We review 3 cases of poses muscle abscesses, characterized by a long-term evolution until revealing the initial source of the abscess and by particular clinical features, due to the exteriorization of suppuration far away from its source (retrosacral, hip, thigh). Computerized tomography is essential for diagnosis and for an accurate therapeutical approach, consisting in incision and drainage of primary abscess in psoas muscle and of its expansions as well in the same time, with an adequate antibiotherapy.

Adult↗

[Primary abscess of the psoas muscle].

An additional case of primary psoas abscess is described. The literature is reviewed and its etiopathogenesis, clinical features, diagnosis and treatment are discussed.

Anti-Bacterial Agents↗

[Spontaneous staphylococcal abscess of psoas muscle].

An abscess of the psoas muscle is a rare occurrence and pathogenetic interpretation usually proves difficult. Abscessing of the psoas may be due either to direct diffusion of infections of adjacent structure or to hematogenous spread. However, not uncommonly, a "spontaneous" abscess occurs, which cannot be correlated to other sites of infections or sepsis. The Authors describe two cases of abscesses of the psoas muscle following Staphylococcus aureus sepsis of unknown origin.

English Abstract↗

Differentiation of psoas muscle abscess from septic arthritis of the hip in children.

A 20-year review was conducted of children presenting with psoas abscess at two major pediatric hospitals. Eleven children with psoas abscesses were identified. The extreme variability in the clinical presentation of this condition is shown. Psoas abscess was most difficult to differentiate from septic arthritis of the hip in pediatric patients. This study also shows the often circuitous investigative route traversed before arriving at the diagnosis of psoas abscess. Atypical features, such as femoral nerve neurapraxia or bladder irritability in association with hip pain, should alert the clinician to consider psoas abscess. Based on this study, a diagnostic algorithm to differentiate between psoas abscess and septic hip was formulated.

Algorithms↗

[Bilateral abscess of the psoas and systemic lupus erythematosus].

Herein we describe a patient with systemic lupus erythematosus and bilateral psoas abscess, an uncommon condition caused by septic metastases from ulcerous necrotic lesions involving both lower limbs. We describe the clinical features and the complementary work up, which included ultrasound. Similarly, treatment is described, as well as the results yielded by bacteriologic analyses of pus specimen. The literature is reviewed, highlighting the most important criteria.

Abscess↗