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PubMedDate not supplied

Group A streptococcal necrotizing fasciitis of the psoas muscle.

Group A streptococci are common colonizers of the skin and upper respiratory tract. Serious infections of the respiratory tract as well as the skin and soft tissue are common. Highly virulent Group A streptococci are not infrequently the cause of invasive, life-threatening infections. Necrotizing fasciitis is uncommon and rarely the result of Group A streptococci. Necrotizing fasciitis of the psoas from Group A streptococci has been reported as a complication in patients with colon cancer perforation or peritonitis. We report the first case of Group A streptococcal necrotizing fasciitis of the psoas muscle not associated with peritonitis or colon perforation.

Adult↗
PubMed2004

[Primary retroperitoneal tumors in adults].

Primary retroperitoneal tumors are rare and most of the time malignant. Because of the large space in which they grow, they are often discovered lately as they are large. CT and MR are the imaging techniques of choice for the primary diagnosis and the follow up of these tumors. Multiplanar reconstructions , signal and density resolution help for the nature diagnosis. The examinations allowed to find associated signs that helps also for the right diagnosis. The purpose of this paper is to answer a serie of questions: Is the mass in the retroperitoneal space? Are they imaging signs that helps for the diagnosis of nature? Are they associated signs that helps for the diagnosis of nature? What are the most common diagnosis? Is there any place for percutaneous biopsies? What is the role of imaging in the follow up? Are there any other processes that can mimic retroperitoneal tumors?

Adrenal Gland Diseases↗
PubMed2002

Low back pain.

Explore the source record for details and available documents.

Amphotericin B↗
PubMed2005

Ten-year experience with surgical repair of mycotic aortic aneurysms.

BACKGROUND: Mycotic aneurysm remains a lethal pathologic entity, especially when rupture occurs. It may result from primary aortitis, be induced by septic emboli, or be secondary to an adjacent infection, such as pancreatitis or a psoas muscle abscess. Surgical intervention is the only way to treat such disease. Even when successful repair is achieved by insertion of an interposition in situ graft or by performance of an extra-anatomic bypass, the prognosis is poor. The aim of this study was to present our experience of managing mycotic aortic aneurysms during the past 10 years. METHODS: From January 1994 to June 2004, a total of 734 patients with aortic aneurysms underwent surgical repair at our institution. Among these cases, 17 (2.3%) were shown to be mycotic aneurysms of the ascending aorta (n = 1), aortic arch (2), thoracic and thoracoabdominal aorta (3), or abdominal aorta (11); 14 patients (mean age, 58.8 years) were male. Preoperative imaging studies were performed in all patients. Mycotic aortic aneurysms were suspected in 12 of the 17 patients (70.6%) preoperatively, and 4 of these 12 patients were found to have ruptures on imaging. At the time of surgery, 9 of the 17 aneurysms (52.9%) were ruptured. Fifteen patients had an interposition graft inserted after meticulous debridement, 1 underwent an aorto-aortic bypass, and 1 underwent an extra-anatomic (axillo-femoral) bypass. An omentum patch was applied to wrap the graft in 8 of 11 mycotic aortic aneurysms of the abdominal aorta. The most common pathogens were Salmonella spp. (n = 7) and Staphylococcus spp. (4). All patients received antibiotic therapy, according to the culture report, for about 4-6 weeks postoperatively. RESULTS: In-hospital mortality was 11.8% (n = 2). Another patient died from massive upper gastrointestinal bleeding 6 months after operation because of complications involving an aorto-duodenal fistula, and another died from stomach cancer 6 years after surgery. Long-term follow-up (mean, 37 months; range, 3-111 months) revealed that, at the time of writing, the remaining 13 patients were alive and well, without any recurrence of aneurysm. CONCLUSION: Mycotic aneurysm of the aorta is a life-threatening disease, especially when rupture occurs. The high mortality rate is due not only to the high rupture rate, but also to sepsis. When mycotic aortic aneurysm is diagnosed, early surgical intervention is mandatory.

Adult↗
PubMed2003

Ultrasound-guided botulinum toxin injection technique for the iliopsoas muscle.

Intramuscular botulinum toxin A injections are beneficial for the treatment of functional shortening of the iliopsoas muscle, but it is difficult to achieve precise needle positioning and injection. As a solution to this we present an ultrasound-guided injection technique for the iliopsoas muscle using an anterior approach from the groin. The procedure was performed 26 times in 13 patients (seven males, six females; mean age 11 years, SD 9 years 8 months; age range 4 to 31 years), 10 times bilaterally. Indications were functional iliopsoas shortening due to cerebral palsy (17 hips), hereditary spastic paraplegia (four hips), and Perthes disease (five hips). In all cases the iliopsoas muscle was identified easily by ultrasound; the placement of the injection needle and injection into the site of interest were observed during real time. No complications were encountered. Botulinum toxin A (BTX-A) injections have become established as a standard procedure for the treatment of functional shortening of different muscles in persons with spasticity or dystonia (Kessler et al. 1999, Bakheit et al. 2001, Kirschner et al. 2001). Optimal needle placement is essential to avoid severe side effects and to assess lack of response to the drug or incorrect region of injection. While injection into superficial, very palpable muscles is quite easy, the approach to other muscles such as the iliopsoas muscle may be more difficult and the placement of the needle for an optimal injection site is harder to control. As a solution to this, we present an ultrasound-guided injection technique. The main indications for BTX-A injections in the iliopsoas muscle are dynamic hip flexion deformities mostly due to spastic conditions which may compromise walking (increased anterior pelvic tilt during the whole gait cycle, decreased hip extension at terminal stance, increased peak hip flexion during swing; Molenaers et al. 1999. Another indication might be decentration of the femoral head (as part of an injection programme which also includes other muscles like the adductors and the medial hamstrings) for pain relief, reducing care difficulties and, possibly, prevention of further decentration (Porta 2000, Foster et al. 2001, Deleplanque et al. 2002, Lubik et al. 2002). In Perthes disease, BTX-A injections in the iliopsoas muscle and the adductors may prevent a fixed deformity, which is a negative prognostic factor.

Adult↗
PubMed2004

[Repeated improper intravenous injection of fentanyl from a transdermal system].

We report on a 30 year-old male who misused transdermal fentanyl. He injected the contents of transdermal patches intravenously. Suffering from chronic pain following total hip replacement, he had received a prescription for this drug formulation from his general practitioner. During his stay in a pain clinic he was able to obtain a total of 13 fentanyl patches from other patients or local pharmacies. He became seriously ill with multiple organ dysfunction in the course of an infection of his thigh. After surgical and intensive care treatment he recovered soon, but the hip prosthesis had to be explanted. There are some reports in the literature of misuse of fentanyl patches. The contents may be ingested orally, or they can be inhaled. Aspirated with a syringe the content of fentanyl patches can also be injected intravenously, sometimes resulting in exit-us. Prescribers must be aware of the potential for abuse of fentanyl patches which can be stolen, sold or even removed from dead bodies.

Administration, Cutaneous↗
PubMed2006

[Gas gangrene with ulcerative colitis under immunosuppressive therapy: report of a case].

We report on a 30-year-old male with ulcerative colitis who developed a spontaneous gas gangrene in the right limb, the gluteal muscles and the retroperitoneal region under immunosuppressive therapy. In spite of immediate aggressive surgical and antibiotic therapy the massive infection led to septicemia and ultimately death. Clostridium septicum was identified with multiple local manifestations in the skeletal muscles. Gas gangrene is extremely rare in patients with ulcerative colitis or Crohn's disease and immunosuppression. The therapeutic options are discussed and the relevant present literature is reviewed.

Adult↗
PubMed2002

A non-infective cause of recurrent purulent arthritis.

We describe a case of recurrent attacks of acute sterile pyogenic arthritis in a 66-year old man. Seven years after the first presentation the diagnosis of acute disseminated fatty necrosis (DFN) was made.

Acute Disease↗
PubMed1993

Tuberculous spondylitis and intermittent chemotherapy in childhood.

The general characteristics and treatment of childhood tuberculous spondylitis are reviewed. Most of the patients (79 per cent) were under 5 years old with girls being in greater number. Twenty-six patients used classical antituberculous chemotherapy and five were given intermittent chemotherapy. There was no significant difference in the mean period of inactivation of the disease (2.8 v. 2.9 months) or in post-treatment angle of kyphosis (33 degrees v. 37.6 degrees) between the classical and intermittent chemotherapy groups. In addition to drug therapy, plaster jacket and immobilization were adequate in four children whereas 27 underwent surgery with only two requiring radical operations. In children with tuberculous spondylitis, intermittent drug treatment is a good alternative due to effectiveness and convenience of use and radical surgery should be reserved for selected cases.

Child, Preschool↗
PubMed1991

Rheumatic fever, reactive arthritis, and musculoskeletal infections in children.

Infections may cause musculoskeletal symptoms either by inducing reactive disease or by directly infecting bone, joints, or muscle. Differentiation of reactive disease from direct infections of the musculoskeletal system is an important clinical problem. Both reactive disease and direct infections result from interactions of the host, the environment, and the infecting agent. This review provides an update of the recent literature on rheumatic fever, the classic example in rheumatology of reactive disease, and direct musculoskeletal infections.

Arthritis, Infectious↗