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At least 19 recordsLinked to original sources
PubMed1995

Successful medical treatment for staphylococcal vertebral osteomyelitis complicated by spinal epidural abscess, psoas abscess and meningitis: a case report.

A 42 year-old farmer was transferred to our hospital for recently exaggerated lower back pain. Neurological examination revealed an L4 radiculopathy on the right side. Meningitis developed after admission. MRI showed L4-5 osteomyelitis and discitis with contiguous spinal epidural abscess and right psoas abscess. Blood culture and CSF culture both grew Staphylococcus aureus. Because the patient refused to receive a drainage procedure, we gave him antibiotics which resulted in a favorable outcome.

Abscess↗
PubMed1997

The value of 67Ga-citrate scanning in psoas abscess.

Psoas abscess is a serious health problem which presents with non-specific symptoms and signs. To reduce morbidity and mortality, it is important to diagnose the presence and extent of a psoas abscess accurately using imaging studies. Because the 67Ga scan may facilitate the early diagnosis of insidious infection and assist CT-guided percutaneous drainage of the abscess, we examined the value of 67Ga scans in 18 patients with psoas abscess. The imaging results of 67Ga scans (18 patients), computed tomography (CT) (16 patients) and bone scans (13 patients) were analyzed. In this series, concomitant infections were very common (94%) in patients with psoas abscess. For detecting psoas abscess, the sensitivity of 67Ga scanning (92%) and CT (91%) was similar. However, 67Ga scanning is superior to CT in demonstrating concomitant infectious foci at other sites. Bone scanning is a sensitive tool for depicting osteomyelitis, which was common in this series of patients. We also found that increased vascularity in the psoas area was demonstrated by three-phase bone scanning in 60% of patients.

Adult↗
PubMed1990

Ectopic ureter presenting as a psoas abscess.

Psoas abscesses are uncommon infections whose etiology may be primary or secondary. We report on a boy with ureteral ectopia presenting as a secondary psoas abscess. The diagnosis of a psoas abscess is protean and should be considered in all patients, particularly children, who present with acute thigh or hip pain and fever.

Abscess↗
PubMed1996

[Psoas abscess].

Psoas abscess is a rare infection, which can present a diagnostic challenge. The classical symptoms are fever, rigor and pain in the loin, lower abdomen, groin or hip, as well as a characteristic limp, but these symptoms can vary. The general health can deteriorate with delayed diagnosis and anemia, weight loss and anorexia can develop. CT is the best diagnostic method to demonstrate the localization and extent of the abscess and also possible sources of infection in the neighbourhood. 14 cases of psoas abscess, which were largely diagnosed and treated in the urological department, are presented and the clinical spectrum of this infection is discussed.

Adult↗
PubMed1995

Retrofascial nontuberculous psoas abscess.

Psoas abscess is usually associated with tuberculous spondylitis, but also occurs in relation to inflammatory bowel disease. We present 17 cases of primary pyogenic psoas abscess seen during a 10 year period at the King Fahd Hospital, Al-Khobar. There were 13 males and 4 females with a mean age of 24.9 years (range one to 55 years). Five patients had sickle cell disease. The average delay in presentation was 4.5 weeks (range 2 to 9 weeks). Pyrexia and a painful hip with a flexion deformity were the most obvious signs. The sedimentation rate and white cell count were markedly raised in every case. Staphylococci were cultured in 10 and anaerobic streptococci, salmonella and E coli in 2 each. Ultrasonography, CT and MR imaging were used to confirm the diagnosis. Early recognition and drainage are important to ensure a rapid recovery.

Adolescent↗
PubMed1997

[A case of hepatocellular carcinoma complicated with psoas abscess].

Psoas abscess is relatively rare and often difficult to make early diagnosis. We treated a patient suffering from hepatocellular carcinoma due to hepatitis C virus infection who was admitted to our hospital complaining of right inguinodynia and a high fever. Positive CRP test were seen. Staphylococcus aureus was detected from blood culture and he was treated for sepsis with antibiotic therapy. After starting treatment, his inguinodynia continued and abscesses were demonstrated in the right psoas muscle by pelvic computed tomography (CT). The abscesses were drained and a specimen yielded S. aureus on culture. After drainage, the symptoms improved and the abscesses disappeared on pelvic CT. Pelvic CT can be successfully used to diagnose psoas abscess and to monitor the efficiency of the treatment.

Aged↗
PubMed1998

The specific gallium-67 scan uptake pattern in psoas abscesses.

A psoas abscess is a rare clinical entity that presents diagnostic and therapeutic challenges. In this retrospective study, we reviewed gallium-67 scan findings in cases of psoas abscess to determine the specific uptake pattern and the usefulness of 67Ga scans in diagnosis and management. Fifteen psoas abscess lesions in 13 patients who had undergone a 67Ga scan during an 8-year period were found in the hospital computer. All but two of the patients had been diagnosed as having fever of unknown origin, urinary tract infection or another irrelevant disease prior to the 67Ga scan. Of the 15 psoas abscess lesions, 12 (80%) could be clearly diagnosed on the basis of the specific 67Ga uptake pattern, in which: (1) the oblique direction of the 67Ga-avid lesion correlates with the orientation of the psoas muscle from the lumbar region to the hip joint region; (2) the lesion does not cross the abdominal midline; (3) the lesion goes through the inguinal region; and (4) the lesion involves at least two-thirds of the whole length of the psoas muscle. The specific features may help in the differentiation of psoas abscess from other intra-abdominal lesions or normal bowel distribution, especially with single-photon emission tomographic images. In 7 of 13 patients (53.8%) the 67Ga scan findings contributed to the clinical management of the patients by first detecting the focus of the infection. Multiple concomitant 67Ga-avid lesions were found in ten patients. In conclusion, the specific features as well as the whole-body survey with 67Ga scan are useful and important in the diagnosis of psoas abscesses and the detection of unexpected concomitant multiple infectious foci in clinically suspicious infectious disease patients.

Adult↗
PubMedDate not supplied

[Diagnosis and therapy of psoas abscess].

PROBLEM: Psoas abscesses are really rare so that the diagnostic onset is commonly very late. The differential diagnosis to other retroperitoneal processes is therefore important. METHOD: In a period of observation of 6 years 21 patient were treated with psoas abscesses. The evaluation of 16 records was done retrospectively under consideration of etiology, history, clinical examination, lab results and x-ray/CT/MRI etc. RESULTS: With the knowledge of the anatomy of the ilio-psoas muscle the clinical examination gives us important information about the diagnosis of psoas abscess. The history and the clinical examination precede the further diagnostics and are condition for high rates of sensitivity and specificity. Lab results indicate an absedation without being specific. The exclusive position of radiological diagnostics is undisputed. Ultrasound, x-ray and leucocyte marked bonescan are proven to be helpful in cases of unknown location of the abscesses. Method of choice seems to be the contrast enhanced CT-scan. The differential diagnosis includes gastrointestinal or renal disorders as well as pathology of bone or joints. In our cases differential diagnosis was complicated since the diagnostic onset was delayed and the initial therapy was not adequate. The diagnosis "abscess of the psoas" does not imply a general regime for therapy therefore an individual treatment in consideration of percutaneous and operative drainage has to be recommended. In selected cases a combination therapy is advised. CONCLUSION: In every case of retroperitoneal symptoms the differential diagnosis of an abscess of the psoas has to be regarded. The diagnosis is subtil and requires clinical and laboratory examinations as well as contrast enhanced computerscan. The therapy follows operative measures. The technique has to be individually decided.

Adult↗
PubMed1988

Paraparesis in a patient with Crohn disease resulting from septic arthritis of the hip and psoas abscess.

A psoas abscess is a recognized complication of Crohn disease. Less commonly, septic arthritis has been described with this entity. The occurrence of both these complications together in Crohn disease is quite rare. A 56-year-old patient with Crohn disease presented with weakness and pain in both lower extremities. Computerized body tomograms demonstrated a large psoas abscess with fistulous connections to the bowel as well as extending into the capsule of the left hip joint. X-ray examination revealed evidence of acute septic arthritis. Electromyographic studies demonstrated lumbosacral plexus involvement bilaterally. The patient subsequently underwent ileocolectomy with drainage of the left psoas abscess, followed by extensive inpatient rehabilitation. Some immediate strength improvement was noted bilaterally. At discharge, the patient remained paraparetic. In patients with known history of Crohn disease, a psoas abscess should be considered when there are symptoms of lower extremity pain, hip flexion contractures, and progressive weakness.

Abscess↗
PubMed1997

[Hydronephrosis in the course of primary psoas abscess].

Primary psoas abscess is rare and presents a difficult diagnostic challenge. We present an unusual case of primary psoas abscess causing hydronephrosis in a 11-year-old boy. The presence of hydronephrosis complicated diagnosis, that was definitely confirmed by computerized tomography. Percutaneous drainage of the abscess under ultrasonography guidance combined with antibiotic therapy provided an effective treatment. Culture of the pus showed Staphylococcus aureus. The subject is discussed noting incidence, etiology and methods of treatment of primary and secondary psoas abscesses.

Child↗
PubMed1990

The use of ultrasound in the management of primary psoas abscess.

Whereas psoas abscess secondary to many local intra- and extra-peritoneal septic processes is well recognised, primary psoas abscess is much less common and the diagnosis is often delayed, leading to significant morbidity and mortality. A case of primary psoas abscess is described and the role of ultrasound in the investigation and management is discussed.

Abscess↗
PubMed1984

Psoas abscess.

A psoas abscess is infrequently diagnosed on initial presentation. This report reviews the presentation of a patient with a complicated psoas abscess. The pathophysiology and the clinical and laboratory presentation of patients with this disease entity are reviewed.

Abscess↗
PubMed1994

General peritonitis induced by rectal examination: an unusual complication of primary psoas abscess.

Primary psoas abscess is a relatively rare disease with highest incidence in children and adolescents. It usually presents with fever, abdominal pain and limp. Limping tends to incriminate musculoskeletal problems below the pelvis, but movement of the hip involves the psoas muscle which is mostly retroperitoneal and intimately related to pelvic and intraperitoneal organs. Although the current tendency is to use abdominal sonography, rectal examination is still a valuable step in clinical examination, and may help to assess a pelvic mass or abscess. The following case report describes the elusive nature of psoas abscess and a rare occurrence of abscess rupture and peritonitis, immediately after rectal examination.

Child, Preschool↗
PubMed1992

Psoas abscess following ingestion of psoas.

A case of right psoas abscess that was caused by duodenal perforation following the ingestion of a wooden skewer from a filet mignon is presented. Surgical repair of the perforation, drainage of the abscess and 5 days of intravenous antibiotics resulted in prompt recovery.

Duodenal Diseases↗
PubMed1994

Secondary psoas abscess twenty-seven years after nephrectomy.

Abscesses of the psoas muscle are due to a hematogenous dissemination, to the spread of infection from adjacent intestinal structures, to osteomyelitis of the spine or to tuberculous infection of a disc space. In contrast, psoas abscesses related to the urological tract have only been described on exception. The present report focuses on a right psoas abscess which developed 27 years after a nephrectomy. The infectious process resulted from the spread of an acute vesical infection through the residual ureter. Analysis of 4 other cases reported in the literature allows us to delineate the clinical features of psoas abscesses of urological origin.

Aged↗
PubMed1985

Psoas abscess complicating Crohn's disease.

Psoas abscess classically was described as secondary to tubercular spondylitis but now more frequently is a complication of an intraabdominal process such as Crohn's disease. Less well recognized is that the fever, flexion contracture of the hip, and weight loss characterizing psoas abscess may be the first indications of Crohn's disease; in fact, gastrointestinal symptoms may be completely absent. Psoas abscess was the first sign of Crohn's disease in 11 of 46 reported patients. We present three additional patients; two were asymptomatic before psoas abscess formation. Only seven of 26 patients whose sole surgical procedure was drainage had subsequent resolution of the abscess. When drainage was combined with bowel resection, 14 of 18 patients (77.8%) were cured by the initial procedure. Thromboembolic complications occurred in four patients (8.3%). Effective therapy when psoas abscess complicates Crohn's disease, includes appropriate antibiotics, drainage, resection of fistulous intestine, and antithrombotic prophylaxis.

Abdominal Muscles↗
PubMed1993

Ga-67 imaging in primary and secondary psoas abscess.

Primary and secondary psoas abscesses are uncommon and frequently misdiagnosed. Two cases of pyogenic psoas abscess are presented to illustrate the usefulness of Ga-67 scintigraphy in determining the presence and the extent of the infectious process.

Adolescent↗