1/90. Obturator internus muscle abscess in children: report of seven cases and review.Obturator internus muscle (OIM) abscess is an uncommon entity often mistaken for septic arthritis of the hip. We describe seven children with OIM abscess and review seven previously reported cases. The most common presenting symptoms were hip or thigh pain (14 patients), fever (13), and limp (13). The hip was flexed, abducted, and externally rotated in 11 patients. magnetic resonance imaging and computed tomography (CT) were diagnostic for OIM abscess in the 14 patients. Associated abscesses were located in the obturator externus muscle (5 patients), psoas muscle (2), and iliac muscle (1). The etiologic agents were Staphylococcus aureus (8 patients), streptococcus pyogenes (2), neisseria gonorrhoeae (2), and enterococcus faecalis (1). Three patients underwent CT-guided percutaneous drainage, and three had surgical drainage. Three patients had ischial osteomyelitis in addition to OIM abscess. The 11 children with uncomplicated OIM abscess were treated for a median of 28 days. All patients had an uneventful recovery.- - - - - - - - - - ranking = 1keywords = abscess (Clic here for more details about this article) |
2/90. Pubic pain in athletes: a case due to an abscess in the obturator muscle.Pubic pain is a common symptom in soccer players. Its cause can be difficult to determine. We report a case in a 19-year-old soccer player who had an abscess in the obturator internus muscle. We are aware of only one similar report in the literature. Painful limitation of internal rotation of the hip and evidence of infection suggested the diagnosis, which was confirmed by magnetic resonance imaging. In a soccer player, a fever and groin pain do not always indicate osteitis pubis. Limitation of internal rotation of the hip should suggest a lesion in the obturator internus muscle.- - - - - - - - - - ranking = 0.5keywords = abscess (Clic here for more details about this article) |
3/90. Primary iliac muscle abscess due to staphylococcus aureus.A 55-year-old man presented with a 3-day history of lower back pain and right thigh pain. A diagnosis of discogenic pain had been made at two other hospitals. He had been admitted to a medical center for acute hepatitis 5 months prior to this admission. Large doses of parenteral hydrocortisone were used for 13 days to treat acute hepatitis. At the present admission, he was unable to stand and refused to move his right leg. There was mild tenderness in the right lower abdomen on deep palpation. Passive flexion and rotation of the right hip produced mild pain, while passive extension of the right hip produced severe pain and resistance. The Patrick test was positive and the psoas sign was present on the right side. The erythrocyte sedimentation rate (ESR) was 66/hr. The c-reactive protein (CRP) level was 0.161 g/L. Abdominal sonography showed a lobulated mass in the right iliac fossa. magnetic resonance imaging showed severe swelling of the right iliac muscle with a central heterogeneous mass. debridement, drainage of the abscess, and application of a septopal chain were performed via an anterior retroperitoneal approach, and parenteral cephazolin and gentamicin were administered. A culture of the abscess grew staphylococcus aureus. The ESR and CRP concentrations decreased to within the normal ranges 3 weeks later. awareness of this disease entity, careful physical examination, and appropriate imaging studies such as ultrasonography and magnetic resonance imaging are key to making a correct diagnosis.- - - - - - - - - - ranking = 0.6keywords = abscess (Clic here for more details about this article) |
4/90. Iliopsoas haemophiliac pseudotumours with bowel fistulation.Two cases of iliopsoas haemophilic pseudotumours are presented. In one patient a fistula developed between a pseudotumour and the large bowel. This resulted in an abscess involving the pseudotumour and adjacent tissues. It resolved after 5 years of therapy involving percutaneous drainage and closure of the fistula. The second patient had a massive pseudotumour that had obstructed both ureters. Later he suffered a fatal mixed Gram negative septicaemia probably related to erosion into the colon.- - - - - - - - - - ranking = 0.1keywords = abscess (Clic here for more details about this article) |
5/90. osteomyelitis of the spine and abscess formation in the left thigh after stent-graft implantation in the superficial femoral artery.PURPOSE: To present a rare case of abscess formation around a covered stent in the superficial femoral artery. methods AND RESULTS: Two weeks after balloon dilation of a left superficial femoral artery (SFA) occlusion, during which a Hemobahn covered stent had been placed to treat dissection, a 77-year-old nondiabetic male developed intolerable pain and swelling of his left thigh. An abscess had formed around the stent, which was patent; intravenous antibiotic therapy quelled the symptoms, and the patient discontinued his oral antibiotic regimen weeks after discharge. General septicemia ensued. Acute lower limb ischemia and excruciating back pain prompted readmission. The SFA stent-graft occlusion required femoropopliteal bypass; the abscess and spondylodiskitis that had developed in the T12 and L1 vertebrae responded to intravenous antibiotics. The patient is without signs of infection at 6 months. CONCLUSIONS: Local and systemic infections associated with intraluminal prostheses are rare, and prophylactic antibiotic therapy is not commonly employed. Balloon- or device-induced arterial injury may expose the arterial wall to bacterial colonization, suggesting that patients receiving lengthy stents or experiencing arterial injury during angioplasty should receive antibiotics as a precautionary measure.- - - - - - - - - - ranking = 0.7keywords = abscess (Clic here for more details about this article) |
6/90. Calcific myonecrosis: case report and review.Although a rare diagnosis, with few reports in the literature, calcific myonecrosis is a diagnosis that must be entertained in individuals presenting with expanding masses in the muscle compartments occurring years after an initial injury. The authors report a previously healthy 66-year-old man with an expanding right lower extremity mass felt initially to be an abscess. Despite presumably appropriate antimicrobial therapy, the lesion continued to expand, causing pain and loss of function. The patient subsequently underwent extensive debridement and free muscle flap transfer with an excellent outcome. This patient serves to remind us that, although calcific myonecrosis is an uncommonly encountered condition, it must be maintained in the differential diagnosis of an expanding muscle compartment mass.- - - - - - - - - - ranking = 0.1keywords = abscess (Clic here for more details about this article) |
7/90. Submasseteric abscess.The masseteric space is an important tissue compartment of the neck, but disease in it is difficult to diagnose and treat. In this paper a case of a young adult male with an abscess of the submasseteric space is presented. diagnosis was established by computed tomography (CT) of the neck, but the severity of the lesion was not accurately estimated. Surgical intervention was performed and a large quantity of pus was drained. A detailed medical history and clinical examination of the patient as well as CT are important tools in the accurate diagnosis and efficient treatment of the disease.- - - - - - - - - - ranking = 0.5keywords = abscess (Clic here for more details about this article) |
8/90. Iliac osteomyelitis and gluteal muscle abscess caused by streptococcus intermedius.streptococcus intermedius, included in the 'milleri group', is a commensal of the mouth and upper respiratory tract but it has often been associated with various pyogenic infections, such as endocarditis, pneumonia, abdominal or cerebral abscess, rarely with osteomyelitis, and exceptionally with muscular abscess. The first observed case of iliac osteomyelitis with gluteal muscle abscess caused by S. intermedius is reported. It is essential to recognise members of the 'milleri group' as possible agents of bone and muscle pyogenic infection because its management requires a timely diagnosis and prolonged antimicrobial treatment to achieve complete clinical and radiological recovery.- - - - - - - - - - ranking = 0.7keywords = abscess (Clic here for more details about this article) |
9/90. Intraoperative magnetic resonance imaging-guided drainage of nonpalpable abscesses.SUMMARY: Intraoperative magnetic resonance imaging provides the surgeon with powerful, high-resolution, real-time imaging. Procedures may be performed with minimal invasion, with the benefit of reduced tissue damage, improved wound healing, and a better cosmetic result. The authors present a case of a leukemic pediatric patient with a few large, deeply situated, nonpalpable abscesses that were drained successfully with intraoperative magnetic resonance imaging guidance. In this case, this new intraoperative imaging method enabled minimal invasiveness, with fast recovery.- - - - - - - - - - ranking = 0.5keywords = abscess (Clic here for more details about this article) |
10/90. Atraumatic Clostridial myonecrosis: case report and literature review.Clostridial myonecrosis (CM) is a rare, life-threatening infection that is most often associated with recent surgery or skeletal muscle trauma. It usually affects patients with some degree of underlying immunocompromise or vascular insufficiency. Occasionally, CM can occur at remote sites, with seeding from a gastrointestinal source in the setting of malignancy. We report a case of a 75-year-old man who developed rapidly progressive myonecrosis in the right shoulder, without prior trauma, caused by clostridium septicum. On autopsy, this patient was found to have previously undiagnosed radiation colitis with ulcerations and abscess formation, secondary to recent prostate cancer radiation therapy. Although several case reports discuss CM in the setting of bowel malignancy, our case illustrates that non-malignant bowel inflammation may be a sufficient source for the infection. Clinical features of this uncommon disease are discussed, and the relevant literature is reviewed with regard to clostridium septicum as an etiologic agent.- - - - - - - - - - ranking = 0.1keywords = abscess (Clic here for more details about this article) |
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