91/180. Retroperitoneal plexiform neurofibroma mimicking psoas abscesses. Retroperitoneal plexiform neurofibroma is a rare finding in neurofibromatosis type I, or von Recklinghausen's disease. A case of retroperitoneal plexiform neurofibroma mimicking psoas abscesses is reported here with its CT and MRI findings. ( info) |
92/180. paraplegia caused by spinal infection after acupuncture. STUDY DESIGN: Case report of a 64-year-old man with psoas abscesses, epidural abscess and spondylitis after acupuncture. OBJECTIVE: To report a case of paraplegia caused by spinal infection after acupuncture. SETTING: Seoul, korea. CASE REPORT: A 64-year-old man came to an emergency room because of severe back pain. At 3 days prior to visit, the patient received acupuncture therapy to the low back with a needle about 10 cm in length because of back pain. Pain was aggravated gradually for 3 days. escherichia coli sepsis developed with altered mentality during admission. At hospital day 9, he regained his consciousness and was found to have paraplegia. Abdominal computerized tomography (CT) and lumbar spine magnetic resonance imaging (MRI) revealed abscesses of bilateral psoas muscles and spondylitis with epidural abscess. After conservative management with intravenous administration of antibiotics, infection was controlled but the patient remained paraplegic (asia scale C L1 level) without neurological recovery. CONCLUSION: paraplegia might result from complications of an acupuncture therapy. ( info) |
| A case of primary non-tuberculous psoas abscess is reported and the literature reviewed. The aetiology of psoas abscess is varied and there is a worldwide variation in the aetiology. Primary psoas abscess is due to Staphylococcal infection. The pathophysiology, clinical features, diagnosis and treatment are discussed with emphasis on the changing pattern in the aetiology and diagnosis. ( info) |
| This case is presented to emphasize that late infection should be considered in all postoperative patients as a cause of pain. A psoas abscess may remain dormant for many years after an anterior spinal procedure. It should be considered in the differential diagnosis of back pain and lumbar radiculopathy after anterior spinal fusion. The lumbar nerve plexus lies within the psoas muscle, and referred pain patterns may occur in the lumbar nerve distribution. In this case, dysesthesias occurred in the distribution of the genitofemoral nerve. The diagnosis and treatment of a psoas abscess has been greatly aided by use of CT and ultrasound. Either of these modalities may be used for directed percutaneous drainage of the abscess. The presence of metal fixation devices necessitates removal of the hardware in order to ensure eradication of the infection. ( info) |
| Systemic complications of intravesicular BCG for bladder carcinoma are uncommon, and include fever, pneumonia, hepatitis, arthralgias, or skin rash. Local complications of BCG therapy for bladder cancer include cystitis, prostatitis, epididymo-orchitis, granulomatous lymphadenitis, or ureteral obstruction. We believe this is the first case of mycobacterium bovis vertebral osteomyelitis and psoas abscess complicating intravesicular BCG therapy for bladder carcinoma. ( info) |
96/180. Recurrent infections caused by cefotaxime- and ciprofloxacin-resistant salmonella enterica serotype choleraesuis treated successfully with imipenem. We present a case of recurrent infection (infective spondilitis, psoas abscess, and bacteraemia) caused by a single strain of cefotaxime- and ciprofloxacin-resistant and bla(CMY-2)-containing salmonella enterica serotype choleraesuis during a 4-month period in a patient with uremia. The patient was successfully treated with imipenem for 7 weeks. Our observation indicates that a carbapenem might be considered as a drug of choice for the treatment of infections caused by this emerging multi-resistant pathogen. ( info) |
97/180. Primary psoas abscess: report of one case. A 6-year-old girl was admitted to our hospital with the problems of persistent fever, limping gait, and right hip pain. On physical examination, flexion of the right hip with limitation of the range of motion was noted. Tenderness over the right inguinal area was also elicited. Pyogenic arthritis of the right hip was suspected. Aspiration of the right hip joint was negative. Two days later, a careful examination revealed that the Patrick's test was negative and a local tenderness on the right lower abdomen was found. laparotomy was performed under the impression of retroperitoneal abscess. The postoperative diagnosis was psoas abscess. After surgical drainage and antibiotics therapy, she was discharged 2 weeks later with good condition. ( info) |
| We describe a series of twelve patients with a psoas abscess seen in a three-year period in a university hospital and a large teaching hospital in the netherlands. In our series, five of the 12 patients had a primary psoas abscess. The predisposing conditions were intravenous drug use, diabetes mellitus, prostate carcinoma and haematoma in the psoas muscle in a patient with haemophilia A. Seven of the 12 patients had a secondary psoas abscess. Five cases were due to vertebral osteomyelitis including two cases of tuberculosis. In the other two cases it was due to colitis and urinary tract infection. It is remarkable that in our series there was only one patient with a psoas abscess secondary to a disease of the digestive tract, while this is the most common cause of a secondary psoas abscess in the literature. There were two cases of tuberculosis which is an emerging disease again. ( info) |
99/180. Laparoscopic drainage of bilateral tuberculous psoas abscesses. psoas abscess secondary to mycobacterium tuberculosis infection is rare in industrialized countries. Standard treatment options for psoas abscess of any etiology include percutaneous drainage under radiographic guidance and surgery, which is reserved for failure of conservative therapy. A case of bilateral tuberculous psoas abscesses is reported and a surgical method of drainage utilizing a totally extraperitoneal laparoscopic approach is described. ( info) |
| Infections due to nontyphoidal Salmonella are common and their incidence has been increasing in the last few years. Here, we describe a patient with a rupture of abdominal aortic aneurysm associated with a psoas abscess due to salmonella typhimurium. early diagnosis, prompt surgical intervention, and active and prolonged antibiotic therapy are the gold standard for the management of this severe clinical situation. ( info) |