Microbiology and Outcome of Iliopsoas Abscess in 124 Patients (original) (raw)
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Innovative Surgical Sciences
Objectives Iliopsoas abscess (IPA) is an uncommon clinical disease and is often missed to diagnose due to vague clinical presentation. Early treatment with drainage and appropriate antibiotic therapy is necessary before sepsis sets in and become lethal. We conducted this study to evaluate clinical features, etiology, management strategies, and outcomes in patients with IPA from a University Teaching Hospital in Nepal. Methods A retrospective analysis of 32 consecutive IPA cases managed at Tribhuvan University Teaching Hospital, Nepal for the period of January 2019 to February 2022 was carried out. Results The mean age was 42.5 ± 19.1 years (range, 19–75 years) and the male: female ratio was 2.2:1. Two-thirds or more patients presented with fever, limp, fixed flexion deformity and/or low back pain. Ultrasonography (US) was diagnostic in 27 (84.4%) patients. Eighteen (56.3%) patients had primary IPAs, and 14 (43.7%) had secondary IPAs. Thirty (93.7%) patients were managed with US guid...
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2013
Background: Iliopsoas abscess remains a rare condition. Together with a decreasing incidence of tuberculosis infection, pyogenic iliopsoas abscess (PIPA) has become relatively more frequent and represents more than half of iliopsoas abscesses.
Atypical presentation of pyogenic iliopsoas abscess in two cases
Drug discoveries & therapeutics, 2018
Iliopsoas abscess (IPA) is an uncommon diagnosis in medical wards. Herein, we present two unusual cases of IPA. First patient was an elderly diabetic patient who had gas-forming bilateral IPA caused by Escherichia coli. This infection proved fatal and patient succumbed on third day of hospital admission. Second patient was a young boy who had right sided sacroilitis with IPA. Staphylococcus aureus was isolated from the pus culture and patient was successfully treated without any sequelae.
Iliopsoas abscess – A review and update on the literature
International Journal of Surgery, 2012
Iliopsoas abscess is a rare condition with a varied symptomology and aetiology. Patients with this condition often present in different ways to different specialities leading to delays in diagnosis and management. Recent advances in the radiological diagnosis of this traditionally rare abscess have highlighted that there is a lack of evidence relating to its aetiology, symptomology, investigation and management. This article reviews the currently available literature to present a concise and systematic review of iliopsoas abscess.
Surgical drainage of primary iliopsoas abscess--safe and cost-effective treatment
Tropical doctor, 2002
The report evaluates surgical drainage (SD) as a primary treatment of primary iliopsoas abscess (PIA). Seventy-two patients, who underwent SD for PIA at B P Koirala Institute of Health Sciences, Dharan, Nepal were studied. SD was performed through a lower abdominal, extra peritoneel, muscle splitting incision. Ultrasonography was used to diagnose the abscess in 53/54 patients (98%). Staphylococcus aureus was the most frequent organism grown in 45/65 patients (69%). The mean duration of drainage was 3.2 +/- 1.4 days (range, 1-7 days). The treatment was successful in resolving the abscesses in all patients. The mean hospital stay was 9.0 +/- 5.4 days (range, 3-40 days). Two patients (2.8%) developed a recurrence, 10 months and 1 year after the operation, respectively. Another patient developed an incisional hernia. There were no deaths. The average cost of treatment to the patient was approximately Nepali rupees 2800 (US$ 40). Surgical drainage appears to be a cost-effective and safe ...
Iliopsoas abscess in children: report on five patients with a literature review
The Turkish journal of pediatrics
We aimed in this study to present the clinical findings in children with iliopsoas abscess (IPA) and to discuss the diagnosis and treatment. The files of five patients, hospitalized between August 2011 and June 2013 and monitored with a diagnosis of IPA, were reviewed retrospectively. Demographic characteristics, symptoms and signs, laboratory examinations, and diagnostic and treatment methods of the cases were evaluated. Two of the cases were females and three were males, and their ages ranged from 10 to 15 years. Before the diagnosis, the duration of symptoms in patients ranged from five days to one year. The primary symptoms included fever and difficulty in walking. One patient presented with septic shock and had a history of trauma as a predisposing factor. All patients except one had a higher erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) value. Psoas abscess was demonstrated by ultrasonography (USG), except in one patient. Four patients underwent percutaneou...
Primary bilateral iliopsoas abscess in an elderly man
Acta clinica Croatica, 2012
Primary bilateral iliopsoas abscesses in the elderly are very rare in Europe. We report a case of an elderly male misdiagnosed with rheumatic low back pain. The delay in accurate diagnosis and therapy led to severe worsening of his general condition and septic shock. The diagnosis was established by multi-slice computed tomography (MSCT) and the patient was successfully treated by MSCT-guided percutaneous drainage of both psoas muscles. Septic shock and miscellaneous complications required continuous intensive care. The patient was discharged after 42 days of hospital treatment. Antibiotic therapy continued for the next six weeks until his complete recovery. Pain remains the most frequent and predominant symptom of spinal pathology regardless of the etiology. Immunocompromised patients or signs suggestive of bacterial infection require caution and a more comprehensive diagnostic work-up.
Diagnostic and therapeutic challenges of intraabdominal infections
World Journal of Surgery, 1990
With the advances that are being made in many areas of medicine, the surgeon must be familiar with infectious diseases of the peritoneal cavity, which have increased in scope and complexity. In addition to the surgical management of secondary peritonitis resulting from perforation of the gastrointestinal tract, the practicing surgeon may be called on to manage patients with cirrhosis with infected ascitic fluid as well as patients undergoing peritoneal dialySis with infected dialysis fluid. In addition, there is increasing recognition of a group of patients with persistent intraabdominal sepsis or tertiary peritonitis in whom infection is associated with multiple systems organ failure and general depression of the immune system. This article endeavors to present an overview of the diagnostic and therapeutic approaches to these disease entities. Until recently, surgeons were concerned only with secondary peritonitis. With the advances that are being made in many areas of medicine, surgery, and critical care, surgeons must be familiar with other infectious diseases of the peritoneal cavity. These can be classified most simply as primary, secondary, and tertiary. Classic views on peritonitis and its late, but localized, stage.-intraabdominal abscess-no longer apply to all hospitalized patients with peritoneal infection. This article will attempt to define these other types of peritonitis and place them in perspective. Primary Peritonitis Definition and Etiology Primary peritonitis is defined as a diffuse bacterial infection of the peritoneal cavity occurring in the absence of disruption of the gastrointestinal tract. It classically occurred in young girls and was caused by Streptococcus pneumoniae [l]. Although this disease entity appears to be decreasing in incidence in children, it is being recognized with increasing frequency in the adult population. In adults, the presence of alcoholic cirrhosis and ascites is the most frequent underlying risk factor [2]. Cirrhotic ascites is predisposed to infection due to the reduced total protein and complement levels, which result in impaired bacterial opsonization [3]. In patients with cirrhosis with pri