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PubMed1994

[Renal nephrogenic nephroma: an little known exceptional tumor. Apropos of a case disclosed by xanthogranulomatous pyelonephritis].

The authors report a new case of an exceptional benign renal tumour: nephronogenic nephroma, composed of differentiation of the blastema into primitive nephronic formations. It raises the problem of differential diagnosis with adult Wilms' tumour and renal blastematosis. In this patient, it was associated with segmental xanthogranulomatous pyelonephritis, presenting in the form of psoïtis and an abscess of the thigh. Total nephrectomy was performed.

Abscess↗
PubMed1999

Primary Salmonella iliopsoas abscess: a case report.

Primary iliopsoas abscesses are usually hematogenous or seeded via the lymphatic system from an occult focus. Staphylococcus aureus has been reported to be the predominant pathogen, whereas Salmonella sp has rarely been reported to be a major pathogen. We report the case of a 63-year-old woman who presented with a prolonged fever of two weeks' duration. On admission, physical examination revealed tenderness over the left lower abdomen and hip joint, with her thigh in constant flexion. Computerized tomography of the abdomen revealed an iliac fossa abscess. The drained pus culture yielded Salmonella group B. Percutaneous catheter drainage and appropriate antimicrobial therapy with ciprofloxacin eventually yielded good results. There was no evidence of other underlying diseases predisposing the patient to the formation of iliopsoas abscess. Salmonella infection should be considered in the diagnostic protocols of iliopsoas abscess in Taiwan, where salmonellosis is prevalent.

Female↗
PubMed1997

A case of an iliopsoas abscess in a neonate.

The present study describes a male neonate with an iliopsoas abscess. He was born by Caesarean section at 35 weeks and 3 days gestation. At 24-days-old he had a fever and localized swelling of the groin to the femur. By ultrasonography (US) and computed tomography (CT), the swelling was diagnosed as iliopsoas abscess. We treated him through percutaneous needle drainage and antibiotics. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in the culture of the fluid from the abscess and the urine. US and CT were useful for the diagnosis and provided guidance for the needle puncture and follow-up of the iliopsoas abscess.

Age of Onset↗
PubMed1998

Pyomyositis--with special reference to the comparison between extra- and intrapelvic muscle abscess.

Fifteen patients, nine males and six females, diagnosed with pyomyositis from 1988 to 1994, and followed for an average of 69.8 months, were reviewed. Excluding two children, the average age was 56.6 years. Eleven adults (73.3%) had underlying diseases. The lesions were multiple in five patients (33.3%) and a total of twenty-four muscle abscesses, including eleven extrapelvic and thirteen intrapelvic, were identified. When comparing extra- and intrapelvic pyomyositis, intrapelvic pyomyositis presents a diagnostic challenge requiring a high index of suspicion. Distinct clinical features such as local heat and painful swelling were all identified in extrapelvic pyomyositis, but they rarely (in only two of the thirteen lesions) emerged in intrapelvic pyomyositis. The average time from presentation to diagnosis was significantly longer in intrapelvic than in extrapelvic pyomyositis (1.4 vs 9.7 days). Although aspiration showed a high diagnostic rate in extrapelvic muscle abscesses, it was difficult to perform and was occasionally misinterpreted in intrapelvic cases. Routine X-rays were not helpful in making the diagnosis. CT scan was valuable because it provided positive diagnostic findings in all twelve patients who received one. The causative organisms in our patients were Staphylococcus aureus in eight (53.3%), Escherichia coli in three (20%), and Klebsiella in three (20%). Treatments consisted of parenteral antibiotics for all patients, image-guided aspiration in four patients, and surgical drainage in eleven patients. Two intrapelvic pyomyositis patients expired due to sepsis. At the completion of the study, twelve patients were asymptomatic without sequel, and one patient had a recurrence.

Abscess↗
PubMed2002

Clinics in diagnostic imaging (71). Left iliopsoas abscess secondary to vertebral osteomyelitis.

A 26-year-old woman presented with a progressively painful lump at her left groin and upper thigh for five months. She also had intermittent back pain for three years. Radiographs and CT showed osteolytic destruction of the several contiguous thoracolumbar vertebrae with a large left iliopsoas abscess that extended to involve the left gluteus maximus and adductor magnus muscles. She responded well to a course of antibiotics. The role of imaging and imaging features of iliopsoas abscesses are discussed, together

Adult↗
PubMed2003

[Iliopsoas abscess accompanied by epidural abscess--a case report].

A 55-year-old man was admitted to a hospital with pain of the low back as well as the left leg, and fever. He was suspected of suffering from the lumbar disc herniation because of the presence of Lasegue's sign on the first physical examination. Abdominal computed tomography, however, revealed the swelling of the left iliopsoas muscle. Iliopsoas abscess accompanied epidural abscess was confirmed by subsequent magnetic resonance imaging (MRI). Antibiotic therapy was started for the successive 8 days. The fever resolved, but the pain persisted. The abscess extending from the iliopsoas muscle to the epidural space was still seen on the MRI 20 days after the completion of the antibiotic therapy, and he still complained of the pain of his low back and left leg. Therefore, we conducted epidural puncture under fluoroscopic guidance. Approximately 3 ml of pus was aspirated from the epidural space. Then, his complains decreased remarkably. Iliopsoas abscess should be taken into account in case of a patient with pain on the low back and leg and also inflammatory signs such as fever and leucocytosis.

Anti-Bacterial Agents↗
PubMed2006

Percutaneous drainage and continuous irrigation in patients with severe pyogenic spondylitis, abscess formation, and marked bone destruction.

OBJECT: The use of percutaneous suction aspiration has recently become viewed as an effective management strategy for pyogenic spondylitis unresponsive to conservative treatment. What remains unclear is whether it can be effective for severe pyogenic spondylitis in which abscess formation or marked bone destruction is present. The authors undertook a study to clarify answers to this question. METHODS: The authors evaluated clinical and radiographic/neuroimaging data obtained in five patients with severe pyogenic spondylitis, extensive abscesses, and marked bone destruction. These patients had undergone percutaneous drainage and continuous irrigation because open surgery was considered contraindicated in light of their poor general health. The mean period during which continuous irrigation was applied was 9 days (range 7-11 days), and the mean period during which the drainage tube was in place was 19 days (range 13-38 days). All patients suffered from back pain, which was relieved by the percutaneous technique in four patients after a mean of 8 days. The abscesses and inflammation resolved in all patients. Progressive osseous destruction was not observed, and open surgery was performed in only one patient in whom back pain persisted as a result of spinal instability. CONCLUSIONS: After an unsuccessful course of conservative treatment, severe pyogenic spondylitis with abscess formation or marked bone destruction was successfully treated using percutaneous drainage and continuous irrigation. Based on their results, the authors believe that this procedure can be used in patients with severe pyogenic spondylitis that was unresponsive to conservative treatment, particularly in those whose general health is poor.

Aged↗
PubMed2001

[Ultrasound diagnosis of retroperitoneal abscesses in spinal tuberculosis].

Sixty four patients were examined to elucidate the capacities and accuracy of ultrasonography (USG) in the diagnosis of retroperitoneal abscesses by ultrasound and X-ray studies. They were all operated on. Retroperitoneal abscesses were detected in patients (58 observations). X-ray retroperitoneal abscesses aroused doubts in 23% of cases. Ultrasonographic evidence was erroneous in 4.9% of cases. USG may reveal accumulation or absence of liquid pus, define the extent and number of chambers of retroperitoneal abscesses, which is helpful in answering questions as what surgical access should be chosen and what scope of a surgical intervention made. The safety and cost-effectiveness of the procedure allows a follow-up to be made.

Abscess↗
PubMed2002

Uropathogenic Escherichia coli as agents of diverse non-urinary tract extraintestinal infections.

Escherichia coli isolates from 3 consecutively encountered patients with serious, invasive, non-urinary tract extraintestinal infections (pneumonia, deep surgical wound infection, and vertebral osteomyelitis with associated epidural/psoas/iliacus abscesses) were characterized, using molecular methods, as to extended virulence genotype and phylogenetic background. All 3 isolates exhibited virulence genotypes and genomic profiles characteristic of specific familiar virulent clones of extraintestinal pathogenic E. coli (ExPEC), which traditionally have been regarded primarily as uropathogenic or as associated with meningitis. These included E. coli O1/O2:K1:H7, E. coli O18:K1:H7, and a recently described E. coli O11/O17/O77:K52:H18 clonal group (clonal group A). These findings demonstrate the extraintestinal pathogenic versatility of ExPEC clones, which supports the use of an inclusive designation for such strains and suggests the possibility of cross-syndrome protective interventions. They also provide novel evidence that multidrug-resistant epidemic clonal group A can cause extraintestinal infections other than uncomplicated urinary tract infections and can cause them in hosts other than young women.

Aged↗