1/31. Psoas abscesses complicating colonic disease: imaging and therapy.Most surgeons think of psoas abscesses as a very rare condition related to tuberculosis of the spine, but in contemporary surgical practice they are more usually a complication of gastrointestinal disease. A case note study was undertaken on all patients treated for psoas abscess at two large hospitals in the mid-Trent region over a 2-year period. All seven patients presented with pyrexia, psoas spasm, a tender mass and leucocytosis. The diagnosis was made on abdominal radiographs in one patient, CT scan in three, MRI in two, and ultrasound in one. Aetiological factors included Crohn's disease in three, appendicitis in two, and sigmoid diverticulitis and metastatic colorectal carcinoma in one each. Six patients underwent transabdominal resection of the diseased bowel, retroperitoneal debridement and external drainage of the abscess cavity. Percutaneous drainage was performed in one. Two patients had more than one surgical exploration for complications. There were no deaths and the hospital stay ranged from 8-152 days. psoas abscess can be a difficult and protracted problem. Bowel resection, thorough debridement, external drainage and concomitant antibiotics are essential for psoas abscesses complicating gastrointestinal disease. Defunctioning stomas may be necessary. However, in some cases a multidisciplinary approach may be required, as psoas abscesses can involve bone and joints.- - - - - - - - - - ranking = 1keywords = pyrexia (Clic here for more details about this article) |
2/31. 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.- - - - - - - - - - ranking = 0.010413832033591keywords = fever (Clic here for more details about this article) |
3/31. psoas abscess associated with iliac vein thrombosis and piriformis and gluteal abscesses.BACKGROUND: A 14-year-old boy was admitted because of lumbago and high fever. methods/RESULTS: Computed tomography scans revealed psoas, piriformis and gluteal abscesses as well as right iliac vein thrombus. A right femoral venogram demonstrated compression from the psoas abscess and thrombosis of the common iliac vein. Appropriate surgical drainage, administration of antibiotics and anticoagulant therapy were effective in the present case. CONCLUSIONS: This is the first report of primary psoas abscess associated with vein thrombosis and is also unique in that abscesses were multiple without predisposing diseases or trauma.- - - - - - - - - - ranking = 0.010413832033591keywords = fever (Clic here for more details about this article) |
4/31. Unilateral psoas abscess following posterior transpedicular stabilization of the lumbar spine.A case of unilateral psoas abscess in a 58-year-old patient, shortly after posterior lower spine stabilization and fusion for spinal stenosis using transpedicular spine fixation is reported. The diagnosis was delayed because the patient's symptoms were referred to the thigh and the plain roentgenograms were negative for pathology. The technetium scintigram and computed tomography (CT) helped localization, diagnosis and treatment of the psoas abscess. Percutaneous CT-guided drainage was followed by recurrence of the abscess, and open surgical evacuation was performed successfully in combination with antibiotic treatment for 8 weeks. psoas abscess should always be suspected when recurrent pain is associated with fever and elevated erythrocyte sedimentation rate after instrumentation of the lumbar spine. Hardware of a low profile and volume should be used to decrease dead space in the fusion area, and the volume of bone substitutes should be limited for the same reason.- - - - - - - - - - ranking = 0.010413832033591keywords = fever (Clic here for more details about this article) |
5/31. Unusual presentation of psoas abscess in a child.Primary abscess of the psoas muscle is relatively rare in infants and young children. The clinical presentation of the disease, with limping, fever, and abdominal pain, may be confused with conditions such as septic arthritis of the hip, osteomyelitis, or appendicitis. The authors present an unusual case of a ruptured left psoas abscess presenting as generalized peritonitis in a child. J Pediatr Surg 36:1859-1860.- - - - - - - - - - ranking = 0.010413832033591keywords = fever (Clic here for more details about this article) |
6/31. Primary psoas abscess complicating a normal vaginal delivery.BACKGROUND: psoas abscess is a rare and potentially dangerous complication of normal delivery. CASE: We describe a case of primary psoas abscess after normal vaginal delivery. A young woman presented with fever, left back pain, left lower abdominal pain, and hip pain starting on postpartum day 2. Computed tomography demonstrated a large retroperitoneal collection. Aspiration drainage of the abscess under computed tomography guidance isolated streptococcus viridans, which responded to antibiotic therapy and percutaneous drainage with complete resolution. CONCLUSION:A high index of suspicion is necessary for diagnosis of psoas abscess, which should be considered in postpartum patients with pyrexia, back and hip pain, and a normal neurologic examination. Computed tomography is effective for diagnosis and allows percutaneous drainage of the abscess.- - - - - - - - - - ranking = 1.0104138320336keywords = pyrexia, fever (Clic here for more details about this article) |
7/31. Primary psoas abscess. Report of three cases.BACKGROUND: Primary psoas abscesses are a rare clinical entity with subtle and non specific symptoms, most commonly seen in patients predisposed to infections. early diagnosis and appropriate management are therefore challenging aspects for physicians. patients AND methods: We present three patients with primary pyogenic psoas abscess, treated at the Heraklion University Hospital, during a 5-year period. The two male and one female patient, aged 36-51 years were admitted with fever, abdominal pain and a palpable tender mass. RESULTS: The classical sign of limping was absent in all cases. Positive psoas symptoms were detected in only two patients. CT scan accurately confirmed the diagnosis in all cases. The patients were successfully treated with antibiotics and prolonged surgical drainage. staphylococcus aureus was the causative microorganism in the first two and bacteroides fragilis in the third patient. This is the first reported case resulting from this specific bacteria. None of our patients had any predisposing risk factor. CONCLUSIONS: A high index of suspicion is mandatory to enable early recognition of this rare clinical disease. CT scan is the standard diagnostic tool to confirm diagnosis. Prolonged drainage and appropriate antibiotics are essential for the successful treatment of primary psoas abscesses.- - - - - - - - - - ranking = 0.010413832033591keywords = fever (Clic here for more details about this article) |
8/31. psoas abscess as a complication of pyogenic sacroiliitis: report of a case.A psoas abscess is, either primary or secondary, a rare entity for a general surgeon. Images by ultrasonography and computed tomography (CT) can help a general surgeon to make an accurate diagnosis when encountering the patient complaining of unilateral lower abdominal deep pain with fever. A case of pyogenic abscess of the psoas muscle as a result of sacroiliitis in a 22-year-old man is reported herein. The abdominal CT and magnetic resonance imaging scans demonstrated a large multilocular abscess extending along the iliopsoas muscle, and erosion and a widening of the left sacroiliac joint. The abscess was drained with an open surgical approach and the patient responded well to antibiotic therapy. Aggressive surgical and medical treatment is necessary in patients with psoas abscess to prevent complications.- - - - - - - - - - ranking = 0.010413832033591keywords = fever (Clic here for more details about this article) |
9/31. 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.- - - - - - - - - - ranking = 0.010413832033591keywords = fever (Clic here for more details about this article) |
10/31. low back pain at presentation in a newly diagnosed diabetic.insulin dependent diabetes mellitus predisposes to a range of different and unusual infections, including epidural and psoas abscesses. However, they occur mainly in adults with longstanding diabetes. We report the case of a 12 year old boy who presented with diabetic ketoacidosis and low back pain, and was subsequently diagnosed with both a left psoas abscess and an extensive thoracolumbar spinal epidural abscess measuring 20 cm in length. This case report highlights the need to maintain a high index of suspicion for epidural abscesses in children presenting with fever and localised back pain. early diagnosis with appropriate imaging and aggressive management can prevent development of permanent neurological damage as was the case in our patient.- - - - - - - - - - ranking = 0.010413832033591keywords = fever (Clic here for more details about this article) |
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