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Results for “Psoas Abscess”

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PubMed1987

[Bilateral abscess of the psoas with aero-anaerobic digestive flora in advanced tuberculosis].

The authors report a case of bilateral psoas abscess without spondylodiscitis, occurring in the course of an advanced pleuro-pulmonary tuberculosis. The dual bacteriological composition of the pus with an aero-anaerobic flora on direct examination, and mycobacterium tuberculosis in the culture, as well as the presence of an obstructive appendicitis noticed during the surgery, open the discussion of its pathogenesis.

Abscess↗
PubMedDate not supplied

[Psoas muscle abscess: bibliographic review].

OBJECTIVES: To report the clinical characteristics, diagnosis and treatment of psoas abscess. METHODS/RESULTS: We report the case of a 77 year old female patient who was diagnosed of psoas abscess. Due to the unspecific symptoms, she was initially treated as a renal colic. Ultrasound was the test that oriented us to the diagnosis. Percutaneous drainage was effective, checking the resolution using CT Scan. CONCLUSIONS: Psoas abscess is an uncommon pathology the presenting features of which are usually unspecific. CT Scan is the astronomer diagnostic tests and percutaneous drainage has good results and is less aggressive therapeutic option for this disease.

Aged↗
PubMed2002

Ruptured mycotic aneurysm of the iliac artery complicated by emphysematous psoas muscle abscess: report of two cases.

Emphysematous psoas muscle abscess has rarely been described and has not been reported to be associated with ruptured mycotic aneurysm. We report two cases of ruptured mycotic iliac arterial aneurysm complicated by emphysematous abscess of the left psoas muscle. Case 1 occurred in a 70-year-old man and Case 2 in a 63-year-old woman. Both patients presented with fever for several weeks. Clinical clues leading to the diagnosis included a palpable abdominal mass with (Case 2) or without (Case 1) pulsation, blurring of the psoas muscle shadow with abnormal gas distribution on the plain abdominal film (Case 1), and peripheral vascular insufficiency and Salmonella bacteremia (Case 2). Ruptured mycotic aneurysm of the left iliac artery complicated with left psoas muscle abscess was clearly demonstrated by abdominal computerized tomography scan and intravenous digital subtraction angiography in both cases. Causative agents, multi-drug resistant Acinetobacter baumannii and Klebsiella pneumoniae, unusual pathogens for mycotic arterial aneurysm, were cultured from debrided tissue in Case 1, and this finding led to the speculation that the infection was hospital-acquired. The favorable outcome in Case 2 resulted from early vascular surgery and a prolonged course of effective antimicrobial therapy.

Aged↗
PubMed1999

[Vesical cystostomy and psoas muscle abscess. Case report].

The authors report an usually uncommon case of psoas abscess after cystostomy for an acute urinary retention. Ultrasound and CT-Scan investigations suggested the diagnosis with confirmed by CT guided percutaneous drainage. On the basis of this observation, we discuss the mechanism and therapeutic aspects of this complication.

Cystostomy↗
PubMed1984

Psoas muscle abscess due to Yersinia enterocolitica.

A psoas muscle abscess due to Yersinia enterocolitica developed in a 71-year-old man with mild type II diabetes mellitus. There was no evidence of gastrointestinal infection or septicemia, and treatment with computed tomography-directed percutaneous drainage and cefoxitin resulted in cure. This represents the first known reported case of psoas abscess due to Y. enterocolitica.

Abscess↗
PubMedDate not supplied

[Psoas muscular abscess in children].

Symptoms of psoas muscular abscess in children are nonspecific and differential diagnosis is made among diseases included in childreńs acute hip pain syndrome, imaging tests being necessary for diagnostic confirmation. During the first semester of 1995, 48,550 children were examined in Pronto Socorro do Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, four of them diagnosed as having psoas muscular abscess (2 females and 2 males, ages varying from 1 to 12 years). All of them had nonspecific clinical features and diagnosis was confirmed by abdominal ultrasound and/or computerized tomography. Staphylococcus aureus was isolated as the etiologic agent in 3 children, findings similar to the ones in literature.

English Abstract↗
PubMed1998

[Psoas muscle abscess. Description of a series of 19 cases].

Abscess of the psoas muscle (PA) is every more frequently observed in recent years. The PA diagnosed in the authors' center over a period of 91 months are presented, analyzing the main clinical features, microbiologic causal agents, risk factors, treatment and the differences between primary and secondary PA. A total of 19 cases of which 14 were secondary PA (73.7%) and 5 primary PA (26.3%) were diagnosed. The main foci of infection of the former were the bone and the genitourinary tract, with intestinal infection being rare. The most frequent clinical data were lumbar pain with possible irradiation to the lower limb, fever, and leucocytosis with neutrophilia. Gram negative and enteric anaerobes were the bacteria most often identified, followed by Staphylococcus aureus and Mycobacterium tuberculosis. In a high percentage of patients (57.8%) a history of immunodeficiency was reported. In regard to treatment, surgical drainage was performed in 5 cases (26.3%), while ten cases (52.6%) were treated by DPCT. Four patients (21%) were exclusively treated with antibiotics. Recurrence was observed in three cases (15.3%) of the DPCT group requiring new drainage. Of all the cases, 18 were cured while one death occurred, being attributed to the underlying tumoral disease of advanced stage. The authors believe DPCT to be a good therapeutic option in both primary and secondary PA, thereby avoiding the risks of major surgery. In the cases with no underlying immunodeficiency the existence of secondary PA should be discarded as occurred in 7 out of 8 cases with no history of immunodeficiency in this series of patients.

Adult↗
PubMed2002

Xanthogranulomatous pyelonephritis in children: diagnostic and therapeutic aspects.

BACKGROUND: Xanthogranulomatous pyelonephritis (XGP) is an uncommon chronic, inflammatory disease of the kidney. Etio-pathogenesis, diagnosis and management of pediatric XGP is still obscure due to the limited number of cases. Therefore, a retrospective clinical study was carried out to present an updated picture of the entire spectrum of pediatric XGP based on our 30 years' experience covering one of the largest non-collected series treated in a single medical center. METHODS: Records of children who were treated for XGP in our unit from 1970 to 1999, inclusive, were reviewed retrospectively. Information recorded for each patient included age, sex, past medical history, clinical characteristics, diagnostic procedures,treatment methods, histopathologic findings and outcome. RESULTS: 17 children with a mean age of 6.6 +/- 0.8 years, consisting of 15 males and 2 females, were treated for XGP. Eight patients had a urological disease history and 4 of them underwent surgery for urinary calculi and exstrophia vesica repair. The most common presenting symptoms were abdominal pain, fever,weight loss and anorexia. Palpable flank mass was the most common physical examination finding. Left and right kidneys were involved in 10 and 7 patients, respectively. Diagnostic procedures were intravenous pyelography, retrograde pyelography, ultrasound scan and computerized tomography (CT). Renal calculi and/or calcifications and non-functioning kidney were the most frequent findings in radiologic investigations. By combining all these investigations, the preoperative diagnoses were XGP (n = 2), renal and/or perirenal abscess (n = 5), psoas abscess(n = 2), non-functioning kidney due to recurrent pyelonephritis(n = 4), Wilms' tumor and/or renal clear-cell carcinoma (n = 4). XGP was correctly diagnosed in only two patients based on cr findings. Drainage of the renal or psoas abscess was performed in 8 patients as an initial procedure (surgical drainage in 6 and ultrasound-guided percutaneous drainage in 2 patients). Surgical procedures included nephrectomy (n= 13), partial nephrectomy (n=2), nephrectomy and diversion of reno-colic fistula(n= 1), and renal biopsy and nephrostomy (n= 1). Operative and postoperative complications were colonic perforation (n= 3) and wound infection (n = 3). Complications were noted only in patients who underwent nephrectomy without initial drainage procedures. Histopathologic examinations showed diffuse and focal XGP in 14 and 3 patients, respectively. CONCLUSION: XGP should be included in the differential diagnosis of all children presenting with perirenal or psoas abscess, renal mass and/or non-functioning kidney associated with/or without urolithiasis. Clinical awareness and a high index of suspicion is required to achieve the correct preoperative diagnosis and appropriate management. CT seems to be the most valuable imaging method for the diagnosis. We strongly recommend percutaneous drainage of the abscess and adjunctive antibiotic therapy prior to nephrectomy to avoid complications. Complete nephrectomy is the proper treatment for the diffuse form whereas frozen section biopsies followed by partial nephrectomy are mandatory for the proper treatment of focal disease.

Adolescent↗
PubMed1997

Ruptured abdominal aorta secondary to psoas muscle abscess due to Klebsiella pneumoniae in an alcoholic.

An alcoholic patient with low back pain and Klebsiella pneumoniae septicaemia is reported. Computed tomography revealed abdominal aortic rupture associated with a psoas abscess. Aortic ligation above and below the rupture site and an axillo-femoral bypass were performed, but the patient died on the first postoperative day. Alcoholism is a common underlying disease in K. pneumoniae septicaemia and its septic metastasis to the psoas muscle. The prognosis of aortic infection secondary to psoas abscess is very poor once aortic rupture occurs. Prompt abscess drainage following correct diagnosis and arterial reconstruction before aortic rupture are mandatory.

Adult↗
PubMed2002

Psoas abscess-like metastasis from transitional cell carcinoma of urinary bladder.

We report a 70-year-old male who presented with gross painless total haematuria associated with persistent left hip pain of one month duration. Computerised tomography of abdomen revealed a mass on the right lateral wall of urinary and abscess like lesion in the left psoas. He underwent transurethral resection of bladder tumour and ultrasonographical guided tru-cut biopsy of psoas lesion. Histopathology confirmed transitional cell carcinoma with metastasis to left psoas muscle. The presentation highlights the clinical and radiological features along with review of literature of rare metastatic site from transitional cell carcinoma of urinary bladder.

Aged↗
PubMed1994

Pyogenic psoas muscle abscess: report of three cases.

We report three cases of primary psoas muscle abscess. Two of these cases were treated by open drainage through a lumbar incision and the other was by ultrasonography (USG)-guided percutaneous aspiration of the abscess. Antibiotic therapy was also instituted in all cases. Post-operatively, the patients recovered well with no sign of recurrence. USG-guided percutaneous drainage combined with appropriate antibiotic therapy appears to be the first choice procedure for treatment of the primary psoas abscess if correct diagnosis is promptly made and the procedure can be performed.

Adult↗
PubMed2001

Psoas muscle abscess caused by Mycobacterium tuberculosis and Staphylococcus aureus: case report and review.

Tuberculosis psoas muscle abscess is currently an uncommon clinical entity in industrialized countries. It was considered the predominant cause of these abscesses in the early part of the 20th century as a result of complicated Potts disease. We describe the case of a psoas abscess caused by the combination of Mycobacterium tuberculosis and Staphylococcus aureus. In this patient, the abscess was not associated with Potts disease but with osteomyelitis of the iliac crest, in which the evaluation with magnetic resonance imaging was very specific in determining the extent and regional spread.

Adult↗
PubMed1997

Squamous cell carcinoma of the cervix with psoas abscess-like metastasis in an HIV-negative patient.

A psoas abscess-like metastasis of squamous cell carcinoma of uterine cervix was diagnosed in a 50-year-old, HIV-negative woman. While there was complete regression of the primary tumor, the psoas cystic lesion grew in size during chemotherapy, with iliac bone destruction and invasion to the gluteus muscle. A computed tomography-guided bone biopsy was done and histopathologic examination revealed squamous cell carcinoma consistent with the primary lesion. Intratumoral injection of cisplatin and radiotherapy resulted in partial relief of symptoms. This form of aggressive, bone destruction metastasis was hitherto reported only in association with AIDS.

Biopsy, Needle↗
PubMed1996

[A technic of MRT-guided abdominal drainage with an open low-field magnet. Its feasibility and the initial results].

PURPOSE: To test the practicality of MRT-aided drainage using an open low-field magnet and to report on the early clinical results. METHODS: So far seven patients have been treated (four subphrenic abscesses, two psoas abscesses and one pancreatic pseudocyst). The planning of the approach and catheter insertion were carried out under MRT control (Magnetom Open, 0.2 T). Subsequent treatment was controlled by CT and fluoroscopy. Initial puncture was carried out with a non-magnetic 18 gauge Chiba needle. The drainage catheter was introduced by Seldinger's technique in six cases and with a trocar in one patient. RESULTS: In all seven patients drainage could be started successfully. The design of the magnet and coils permitted adequate accessibility of the patient. There were no problems in visualising the puncture needle. Controlling the position of the catheter by MRT was, however, difficult. CONCLUSION: The first two steps in abscess drainage (planning the approach and inserting the catheter) can be carried out under MRT control. For further catheter control and observing the course of the disease we presently prefer CT or fluoroscopy.

Abdomen↗
PubMed1983

[Non-tuberculous abscesses of the psoas. A case of apparently primary abscess of the psoas due to Staphylococcus aureus].

Abscess of the psoas, which is a well recognized complication in tuberculous osteoarticular infections, can also occur in certain regional diseases of the bones or viscera: common germ osteitis, diverticulosis, colic cancer, appendicitis and, above all, Crohn disease. Abscess of the psoas can also present as an apparently primary pyogenic muscular infection. A case is reported of an abscess of the psoas due to Staphylococcus aureus, which occurred spontaneously in an apparently healthy 50-year-old woman, was cured by surgical drainage, and whose course confirmed its primary nature.

Abscess↗
PubMedDate not supplied

Primary psoas muscle abscess diagnosed and treated during pregnancy: case report and literature review.

BACKGROUND: Primary psoas muscle abscess is rare and can be difficult to diagnose, particularly during pregnancy. CASE: To our knowledge, this is the first case of primary psoas muscle abscess diagnosed during pregnancy. Clinical investigation did not reveal any infection spreading from adjacent structures. Surgical drainage and simultaneous Cesarean delivery of the infant, combined with appropriate antibiotics, enabled a cure. CONCLUSION: The possibility of psoas muscle abscess should be taken into account when investigating lower back pain during pregnancy if conventional approaches are unsatisfactory.

Adult↗