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1.
BMJ Case Rep ; 14(2)2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33526521

RESUMO

Vertebral osteomyelitis is an infection of the vertebrae that can lead to spinal degeneration, most commonly caused by Staphylococcus aureus Here, we report an unusual case of pyogenic osteomyelitis caused by Gardnerella vaginalis and Streptococcus parasanguinis in a 61-year-old postmenopausal woman. The patient presented with a 2-week history of worsening lower back pain and fever and a recent episode of cystitis following re-engagement of sexual activity. Imaging revealed a deterioration of vertebrae discs and spinal canal stenosis at the L3-L4 levels with a formation of abscess in the right psoas muscle. Needle aspiration of the abscess identified G. vaginalis and S. parasanguinis and the patient was successfully treated with a 6-week course of ceftriaxone and metronidazole. This case describes an unusual coinfection of two pathogens that normally reside in the urogenital tract and oral cavity, respectively, and highlights the risk posed when these organisms breach the body's normal barriers.


Assuntos
Discite/microbiologia , Gardnerella vaginalis/isolamento & purificação , Vértebras Lombares , Osteomielite/microbiologia , Abscesso do Psoas/microbiologia , Infecções Estreptocócicas/microbiologia , Streptococcus/isolamento & purificação , Antibacterianos/uso terapêutico , Técnicas de Cultura , Discite/diagnóstico por imagem , Discite/tratamento farmacológico , Discite/fisiopatologia , Feminino , Infecções por Bactérias Gram-Positivas/diagnóstico , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Infecções por Bactérias Gram-Positivas/microbiologia , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Osteomielite/diagnóstico por imagem , Osteomielite/tratamento farmacológico , Osteomielite/fisiopatologia , Pós-Menopausa , Abscesso do Psoas/diagnóstico por imagem , Abscesso do Psoas/tratamento farmacológico , Estenose Espinal/fisiopatologia , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico
2.
AJR Am J Roentgenol ; 216(3): 812-823, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33439049

RESUMO

OBJECTIVE. The purpose of this article is to review the spectrum, etiopathogenesis, clinical presentation, imaging features, differential diagnoses, and management of emphysematous infections of the abdomen and pelvis. CONCLUSION. Emphysematous infections are associated with high morbidity and mortality and thus need urgent medical and surgical interventions. CT is the most sensitive modality to detect gas; CT provides definitive diagnosis in most cases and can depict the extent of involvement.


Assuntos
Enfisema/diagnóstico por imagem , Gases , Tomografia Computadorizada por Raios X , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/microbiologia , Abscesso/diagnóstico por imagem , Abscesso/microbiologia , Aortite/diagnóstico por imagem , Aortite/microbiologia , Cistite/diagnóstico por imagem , Cistite/microbiologia , Enfisema/microbiologia , Colecistite Enfisematosa/diagnóstico por imagem , Colecistite Enfisematosa/microbiologia , Feminino , Gangrena de Fournier/diagnóstico por imagem , Gangrena de Fournier/microbiologia , Gangrena Gasosa/diagnóstico por imagem , Gangrena Gasosa/microbiologia , Gastrite/diagnóstico por imagem , Gastrite/microbiologia , Hepatite/diagnóstico por imagem , Hepatite/microbiologia , Humanos , Masculino , Pancreatite/diagnóstico por imagem , Pancreatite/microbiologia , Doenças Prostáticas/diagnóstico por imagem , Doenças Prostáticas/microbiologia , Abscesso do Psoas/diagnóstico por imagem , Abscesso do Psoas/microbiologia , Pielite/diagnóstico por imagem , Pielite/microbiologia , Pielonefrite/diagnóstico por imagem , Pielonefrite/microbiologia , Doenças Uterinas/diagnóstico por imagem , Doenças Uterinas/microbiologia
3.
Vasc Endovascular Surg ; 55(1): 95-99, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32875968

RESUMO

Aortoenteric fistula after endovascular aortic repair for an abdominal aortic aneurysm is a rare but severe complication. Particularly, a case of inflammatory abdominal aortic aneurysm is extremely rare and there are only 3 reported cases. A 70-year-old man underwent endovascular aortic repair for impending rupture of an inflammatory abdominal aortic aneurysm and was medicated steroids for approximately 2 years. Four years after endovascular aortic repair, he developed endograft infection with an aortoduodenal fistula and a left psoas abscess. He underwent total endograft excision, debridement, in situ reconstruction of the aorta using prosthetic grafts with omental coverage, and digestive tract reconstruction to prevent leakage. Pseudomonas aeruginosa was detected in the infected aortic sac. The patient has not experienced recurrence of infection in the 35 months since his operation.


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Implante de Prótese Vascular/efeitos adversos , Prótese Vascular/efeitos adversos , Duodenopatias/microbiologia , Procedimentos Endovasculares/efeitos adversos , Fístula Intestinal/microbiologia , Infecções Relacionadas à Prótese/microbiologia , Infecções por Pseudomonas/microbiologia , Abscesso do Psoas/microbiologia , Fístula Vascular/microbiologia , Idoso , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Implante de Prótese Vascular/instrumentação , Desbridamento , Remoção de Dispositivo , Duodenopatias/diagnóstico por imagem , Duodenopatias/cirurgia , Procedimentos Endovasculares/instrumentação , Humanos , Fístula Intestinal/diagnóstico por imagem , Fístula Intestinal/cirurgia , Masculino , Omento/cirurgia , Infecções Relacionadas à Prótese/diagnóstico por imagem , Infecções Relacionadas à Prótese/cirurgia , Infecções por Pseudomonas/diagnóstico por imagem , Infecções por Pseudomonas/cirurgia , Abscesso do Psoas/diagnóstico por imagem , Abscesso do Psoas/cirurgia , Resultado do Tratamento , Fístula Vascular/diagnóstico por imagem , Fístula Vascular/cirurgia
5.
BMJ Case Rep ; 13(12)2020 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-33372019

RESUMO

A 71-year-old man presented with a 3-month history of low back pain radiating to his right hip and thigh associated with lower limb weakness and constitutional symptoms. Imaging confirmed a lumbosacral spondylodiscitis at L2-3 and L5-S1 as well as a right-side psoas abscess which was treated with urgent CT-guided drainage and intravenous antibiotics. His admission was complicated by a number of issues, including the development of osteomyelitis with vertebral body destruction at multiple sites, epidural abscess formation and deep vein thrombosis. Additionally, the patient developed severe sepsis which necessitated admission to the intensive care unit. The patient's clinical condition improved gradually with intravenous antibiotics until he was well enough for transfer to a rehabilitation centre, where he underwent regular occupational and physical therapy. Repeat imaging showed overall resolution of the aforementioned pathologies and is currently being followed up by the spinal surgeons on an outpatient basis.


Assuntos
Discite/complicações , Abscesso Epidural/complicações , Vértebras Lombares , Osteomielite/complicações , Sacro , Sepse/complicações , Infecções Estafilocócicas/complicações , Idoso , Antibacterianos/uso terapêutico , Discite/diagnóstico por imagem , Drenagem , Abscesso Epidural/diagnóstico , Abscesso Epidural/tratamento farmacológico , Humanos , Dor Lombar/etiologia , Vértebras Lombares/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Osteomielite/diagnóstico , Osteomielite/tratamento farmacológico , Abscesso do Psoas/complicações , Abscesso do Psoas/diagnóstico por imagem , Abscesso do Psoas/tratamento farmacológico , Sacro/diagnóstico por imagem , Sepse/diagnóstico , Sepse/tratamento farmacológico , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/tratamento farmacológico , Tomografia Computadorizada por Raios X , Trombose Venosa
6.
JBJS Case Connect ; 9(4): e0505, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31815807

RESUMO

CASE: We describe a case of septic hip arthritis and enterocutaneous fistula formation caused by the seeding of a hip joint during hip arthroscopy performed in the setting of a psoas abscess. Treatment consisted of multiple debridements and femoral head resection with subsequent total hip arthroplasty. CONCLUSIONS: This case highlights the importance of a thorough history, physical examination, and assessment of available imaging before proceeding to surgery, even when the procedure is one considered to have minimal risks, such as arthroscopy.


Assuntos
Artrite Infecciosa/etiologia , Artroscopia/efeitos adversos , Doença de Crohn/complicações , Fístula Intestinal/complicações , Complicações Pós-Operatórias/etiologia , Abscesso do Psoas/complicações , Adulto , Artrite Infecciosa/diagnóstico por imagem , Erros de Diagnóstico , Articulação do Quadril/diagnóstico por imagem , Articulação do Quadril/cirurgia , Humanos , Fístula Intestinal/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Complicações Pós-Operatórias/diagnóstico por imagem , Abscesso do Psoas/diagnóstico por imagem , Radiografia
8.
J Med Case Rep ; 13(1): 351, 2019 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-31775881

RESUMO

BACKGROUND: Actinomycosis is a chronic, slowly progressive infection caused by the Actinomyces species. Lumbar vertebral involvement of Actinomyces israelii is extremely rare; this is the first case report of lumbar vertebral osteomyelitis and psoas abscess caused by Actinomyces israelii after an operation under general anesthesia. CASE PRESENTATION: A 66-year-old Japanese man with end-stage renal disease was admitted to our hospital for an operation for cervical canal stenosis. After the operation under general anesthesia, during which tracheal intubation and nasogastric tube insertion were performed, he developed low back pain. During a second hospitalization, computed tomography revealed osteolysis of the lumbar endplates of L2 and L3, swelling of the intervertebral disk of L2/L3, and swelling of the left psoas major muscle. Percutaneous drainage of the intervertebral disc was performed, and the culture of the aspirate grew Actinomyces israelii. Based on the susceptibility, ampicillin was administered but his condition did not improve. We changed the antibiotics to ampicillin-sulbactam for coverage of unidentified oral commensals, and his symptoms and signs finally improved. CONCLUSION: Our patient's long-term end-stage renal disease had made the oral and gastrointestinal mucosal barriers very fragile. Under these conditions, even mildly invasive procedures such as tracheal intubation and nasogastric tube insertion could be the cause of infectious complication by oral commensals, including Actinomyces.


Assuntos
Actinomyces , Actinomicose/diagnóstico , Anestesia Geral/efeitos adversos , Falência Renal Crônica/complicações , Osteomielite/diagnóstico , Abscesso do Psoas/diagnóstico , Actinomicose/diagnóstico por imagem , Actinomicose/etiologia , Actinomicose/microbiologia , Idoso , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/microbiologia , Masculino , Osteomielite/diagnóstico por imagem , Osteomielite/etiologia , Osteomielite/microbiologia , Abscesso do Psoas/diagnóstico por imagem , Abscesso do Psoas/etiologia , Abscesso do Psoas/microbiologia , Tomografia Computadorizada por Raios X
9.
J Med Case Rep ; 13(1): 253, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31412911

RESUMO

BACKGROUND: Psoas or epidural abscesses are often accompanied by pyogenic spondylitis and require drainage. Posterolateral percutaneous endoscopic techniques are usually used for hernia discectomy, but this approach is also useful in some cases of psoas or lumbar ventral epidural abscess. We here report a case of psoas and epidural abscesses accompanied by pyogenic spondylitis that was successfully treated by percutaneous endoscopic drainage. CASE PRESENTATION: Our patient was a 57-year-old Japanese woman who had been receiving chemotherapy for inflammatory breast cancer and who became unable to walk due to lower back and left leg pain. She was transported as an emergency to another hospital. Magnetic resonance imaging revealed psoas and epidural abscesses accompanied by pyogenic spondylitis, and methicillin-resistant Staphylococcus aureus was detected in a blood culture. Drainage of the psoas abscess was performed under echo guidance, but was not effective, and she was transferred to our institution. We performed percutaneous endoscopic drainage for the psoas and epidural abscesses. Immediate pain relief was achieved and the inflammatory reaction subsided after 8 weeks of antibiotic therapy with daptomycin. CONCLUSIONS: Percutaneous endoscopy allowed us to approach the psoas and epidural abscesses directly, enabling the immediate drainage of the abscesses with less burden on the patient.


Assuntos
Drenagem/métodos , Abscesso Epidural/cirurgia , Abscesso do Psoas/cirurgia , Endoscopia/métodos , Abscesso Epidural/complicações , Abscesso Epidural/diagnóstico por imagem , Abscesso Epidural/patologia , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/patologia , Imagem por Ressonância Magnética , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Pessoa de Meia-Idade , Abscesso do Psoas/complicações , Abscesso do Psoas/diagnóstico por imagem , Abscesso do Psoas/patologia , Espondilite/complicações , Infecções Estafilocócicas/sangue , Infecções Estafilocócicas/complicações
11.
J Med Case Rep ; 13(1): 47, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30819241

RESUMO

BACKGROUND: Parvimonas micra, a Gram-positive anaerobic coccus, is a rare pathogen for psoas abscess. We describe a case of a patient with iliopsoas abscess caused by P. micra. CASE PRESENTATION: An 81-year-old Asian man presented to our department with complaints of fever since the preceding day. Abdominal computed tomography revealed the presence of a low-density mass in the right iliopsoas muscle indicative of a psoas abscess. Computed tomography-guided percutaneous drainage of the psoas abscess was performed. Results of organism cultures of the abscess and blood were positive for P. micra. However, our patient had no known primary focus of infection. On the basis of these findings, a primary psoas abscess caused by P. micra was diagnosed, and treatment with ampicillin/sulbactam 1.5 g, administered intravenously every 8 h, was initiated. By day 7, the patient's white blood cell count normalized. By day 20, his C-reactive protein level was decreased to 0.35 mg/dl. CONCLUSION: Iliopsoas abscesses caused by anaerobic bacteria are relatively rare, and iliopsoas abscesses caused by P. micra are especially rare. Our patient's case revealed that P. micra can cause iliopsoas abscess. Therefore, clinicians should be aware of the possibility that P. micra may cause iliopsoas abscess.


Assuntos
Antibacterianos/uso terapêutico , Drenagem/métodos , Febre/microbiologia , Infecções por Bactérias Gram-Positivas/patologia , Abscesso do Psoas/patologia , Administração Intravenosa , Idoso de 80 Anos ou mais , Proteína C-Reativa/análise , Infecções por Bactérias Gram-Positivas/microbiologia , Infecções por Bactérias Gram-Positivas/terapia , Humanos , Masculino , Abscesso do Psoas/diagnóstico por imagem , Abscesso do Psoas/microbiologia , Abscesso do Psoas/terapia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Ultrassonografia de Intervenção
12.
Prensa méd. argent ; 105(1): 43-44, mar 2019.
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1026349

RESUMO

This article details the treatment of lymphangioma of the face with intralesional bleomycin: with a case report and literature review. Surgical treatment of lymphangioma of the face is a difficult task to achieve, due to close vicinity of the lesion to the facial nerve and possibility of scar tissue formation. Inefficient surgical removals generally will give rise to high recurrence rates because of infiltrative and diffuse extension of the lesion. However, complete cure has been described by non-surgical methods with intralesional bleomycin injection under ultrasonographic guidance. Lymphangioma is a rare congenital malformation of the lymphatic system, frequently seen in the head and neck. Percutaneous sclerotherapy of lymphangioma involves the injection of sclerosing substances into the lymphangioma. This study aims to evaluate the effectiveness of intralesional bleomycin sclerotherapy in the treatment of lymphangioma, and to determine the incidence of complications in the treatment. Intralesional bleomycin therapy was very effective in the treatment of lymphangioma. Bleomycin administered as intralesional injection was found to be safe as there was no lesions complicating or side effects observed in the study.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Drenagem , Estudos Retrospectivos , Resultado do Tratamento , Abscesso do Psoas/terapia , Abscesso do Psoas/diagnóstico por imagem , Antibioticoprofilaxia
15.
Reumatismo ; 70(4): 264-267, 2018 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-30570246

RESUMO

Infectious sacroiliitis is an infection of the sacroiliac joint, not easy to diagnose because of its non-specific signs, symptoms and laboratory abnormalities. We describe a case of a 16 year-old male with 5 days' history of fever, abdominal pain, constipation, low-back and left hip pain extended to the left knee associated with sudden inability to walk. In the first place, magnetic resonance imaging (MRI) examination of his sacroiliac joint revealed an enlarged corpuscolated fluid collection near the left iliopsoas muscle, extended to homolateral paravertebral muscles and a little fluid at the left sacroiliac joint. Drainage by aspiration of the iliopsoas abscess was applied; Staphylococcus aureus was found in the aspirated fluid and isolated from the blood too. Therefore intravenous antibiotic therapy was begun. Follow-up MRI exams confirmed the muscle abscess and revealed also a spongy bone edema of the left sacroiliac joint, persisting despite the disappearance of symptoms and the normalization of inflammatory values. It is important to make an early diagnosis of infectious sacroiliitis in order to begin antibiotic therapy as soon as possible, because of the increasing morbidity of infection of sacroiliac joint. In our case MR findings have provided significant orientation towards the final diagnosis of infectious sacroiliitis.


Assuntos
Imagem por Ressonância Magnética , Abscesso do Psoas/diagnóstico por imagem , Abscesso do Psoas/microbiologia , Sacroileíte/diagnóstico por imagem , Sacroileíte/microbiologia , Infecções Estafilocócicas , Adolescente , Humanos , Masculino , Abscesso do Psoas/complicações , Sacroileíte/complicações , Infecções Estafilocócicas/complicações
16.
BMJ Case Rep ; 11(1)2018 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-30573534

RESUMO

We report a case of a 33-year-old woman from Nepal who presented to a hospital with paraplegia. She was found to have pulmonary tuberculosis (TB) with lumbar spine involvement, and bilateral psoas abscesses. She had no initial symptoms attributable to pulmonary involvement. Her delayed presentation to the hospital led to complication of TB spine, which compromised the life of this woman working as a labourer. Early diagnosis and treatment of extrapulmonary TB is essential. Awareness regarding symptoms of different forms of extrapulmonary TB and making diagnostic modalities such as CT scan, MRI or biopsy readily available through insurance schemes are some important measures to minimise the problem so that complications like paraplegia as in our patient with spinal TB can potentially be avoided.


Assuntos
Abscesso do Psoas/etiologia , Tuberculose Pulmonar/complicações , Tuberculose da Coluna Vertebral/etiologia , Adulto , Alcoolismo/complicações , Antituberculosos/administração & dosagem , Diagnóstico Tardio , Feminino , Humanos , Laminectomia , Região Lombossacral/diagnóstico por imagem , Nepal , Abscesso do Psoas/diagnóstico por imagem , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose da Coluna Vertebral/diagnóstico por imagem , Tuberculose da Coluna Vertebral/cirurgia
17.
J Orthop Surg Res ; 13(1): 290, 2018 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-30454001

RESUMO

BACKGROUND: Spinal tuberculosis is a frequent cause of psoas abscess (PA), and PA largely negates the efficacy of antituberculosis therapy. This study aimed to investigate the clinical outcome of preoperative percutaneous catheter drainage (PCD) in patients with lumbar spinal tuberculosis and PA. METHODS: Between January 2015 and January 2017, 72 patients with lumbar spinal tuberculosis with PA were assigned to group A (preoperative PCD) and group B (n = 36 per group). All patients received posterior pedicle screw fixation and anterior focal debridement and fusion. Data on intraoperative blood loss, the duration of the surgery, and the length of the anterior incision were recorded, as well as the postoperative anal exhaust time, visual analogue scale (VAS), Cobb angle, lumbar vertebra function, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, and sinus tract formation. RESULTS: Sixty-eight patients were followed up for an average time of 13 months (range 6-21 months). Until the final follow-up, no mixed infections, recurrence of tuberculosis, pedicle screw loosening, or screw pullout had occurred. There were significant between-group differences in blood loss, surgery duration, anterior incisional length, postoperative anal exhaust time, and sinus tract formation. As compared with group B, the ESR and CRP levels of the patients in group A were markedly improved following 3 weeks of antituberculosis therapy and 1 week postsurgery. CONCLUSION: Preoperative PCD helps to increase the efficacy of antituberculosis therapy prior to surgery, reduce surgical trauma, and avoid postoperative complications, making it a safe and feasible treatment option for lumbar spinal tuberculosis with PA.


Assuntos
Cateterismo/métodos , Drenagem/métodos , Vértebras Lombares/cirurgia , Cuidados Pré-Operatórios/métodos , Abscesso do Psoas/cirurgia , Tuberculose da Coluna Vertebral/cirurgia , Adulto , Idoso , Antituberculosos/uso terapêutico , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Vértebras Lombares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Abscesso do Psoas/diagnóstico por imagem , Abscesso do Psoas/epidemiologia , Resultado do Tratamento , Tuberculose da Coluna Vertebral/diagnóstico por imagem , Tuberculose da Coluna Vertebral/epidemiologia , Adulto Jovem
18.
Einstein (Sao Paulo) ; 16(3): eRC4254, 2018 Sep 21.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30281765

RESUMO

The aim of this study were to describe the technique of percutaneous drainage of iliopsoas abscess, and to discuss the benefits of using this minimally-invasive tool. A single center study with retrospective analysis of patients with psoas abscess confirmed by imaging scans, sent to the interventional medicine center and submitted to computed tomography and ultrasound-guided percutaneous drainage, from November 2013 to August 2016. Seven patients underwent percutaneous drainage of psoas abscess in this period. The mean initial drained volume was 61.4±50.7mL (ranging from 10 to 130mL), and the mean drainage duration was 8.3±2.8 days (ranging from 4 to 12 days). The success rate of the percutaneous procedures was 71.5%, and two patients required re-intervention. Image-guided percutaneous drainage of iliopsoas abscess is a minimally invasive, efficient and safe procedure, and an extremely valuable technique, especially for patients who are not suitable for surgical repair.


Assuntos
Drenagem/métodos , Abscesso do Psoas/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Drenagem/instrumentação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Pseudomonas aeruginosa/isolamento & purificação , Abscesso do Psoas/diagnóstico por imagem , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Ultrassonografia de Intervenção , Adulto Jovem
20.
World Neurosurg ; 120: 43-46, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30149157

RESUMO

BACKGROUND: Sequestered disc fragments may present as a lesion with peripheral enhancement on magnetic resonance imaging. When located in the psoas muscle compartment, this finding could mimic an abscess. CASE DESCRIPTION: We describe a case of a 52-year-old man who returned from Togo after 2 years of living in precarious conditions. He was afebrile and complaining of lumbar back pain. The magnetic resonance imaging showed L3 and L4 vertebral body enhancement with bilateral psoas lesions in continuity with the disc space, suggesting spondylodiscitis with a differential diagnosis of inflammatory herniated disc. A computed tomography-guided biopsy of the right psoas lesion was performed to rule out spondylodiscitis. Histology was compatible with extruded disc material. CONCLUSION: Herniated disc fragments should be considered as a differential diagnosis of psoas abscesses. Coronal plane images may show the continuity of bilateral herniated disc fragments, mimicking psoas abscesses.


Assuntos
Degeneração do Disco Intervertebral/diagnóstico por imagem , Degeneração do Disco Intervertebral/patologia , Deslocamento do Disco Intervertebral/diagnóstico por imagem , Deslocamento do Disco Intervertebral/patologia , Abscesso do Psoas/diagnóstico por imagem , Abscesso do Psoas/patologia , Diagnóstico Diferencial , Discite/diagnóstico , Humanos , Degeneração do Disco Intervertebral/cirurgia , Deslocamento do Disco Intervertebral/cirurgia , Masculino , Pessoa de Meia-Idade , Abscesso do Psoas/cirurgia
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