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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
4.
BMJ Case Rep ; 12(11)2019 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-31748364

RESUMO

Parvimonas micra (P. micra) is a Gram-positive anaerobic cocci, normally found in the oral cavity and rarely causes severe infections. We describe a rare clinical presentation of P. micra as spondylodiscitis and psoas abscess with haematogenous spread in an adult patient. MRI lumbar spine detected L2 and L3 spondylodiscitis. Blood cultures were positive at 48 hours of incubation and P. micra was identified on anaerobic culture after 72 hours. Isolates from bone biopsy confirms P. micra She was successfully treated with ceftriaxone, followed by oral metronidzole for a total of 8 weeks. The suspected origin of her P. micra was a dental cavity. Anaerobic bacteria tend to be underestimated in spondylodiscitis. In cases of slow growing organisms, we emphasise the importance of performing accurate identification including anaerobic bacteria to guide management. P. micra should be considered in patients with spondylodiscitis who had recent dental intervention or perioral infection.


Assuntos
Discite/complicações , Discite/microbiologia , Firmicutes/isolamento & purificação , Abscesso do Psoas/complicações , Abscesso do Psoas/microbiologia , Administração Intravenosa , Administração Oral , Idoso , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Biópsia , Osso e Ossos/patologia , Ceftriaxona/administração & dosagem , Ceftriaxona/uso terapêutico , Diagnóstico Diferencial , Discite/diagnóstico por imagem , Discite/patologia , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Metronidazol/administração & dosagem , Metronidazol/uso terapêutico , Abscesso do Psoas/tratamento farmacológico , Resultado do Tratamento
5.
J Orthop Surg (Hong Kong) ; 27(3): 2309499019885446, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31714174

RESUMO

BACKGROUND: Percutaneous endoscopic discectomy (PED) has been reported to be an effective procedure and minimally invasive surgical therapy for various spinal pathologies. OBJECTIVE: To evaluate the clinical outcome of patients with pyogenic spondylitis who were treated with PED. METHODS: Twenty-four patients with pyogenic spondylitis who underwent PED were evaluated for medical history, level of the affected intervertebral space, mode of onset, plain radiographs, epidural or psoas abscesses on MRI, results of blood and intraoperative sample cultures, preoperative C-reactive protein (CRP) level, time until postoperative CRP normalization (CRP < 0.3), and any additional surgery. Patients who underwent additional surgery and showed uncontrollable inflammation were considered to have "failed" PED for pyogenic spondylitis. To elucidate the factors that were significantly associated with a failure of PED for pyogenic spondylitis, statistical analyses were conducted by univariate analysis. RESULTS: Control of inflammation was achieved in 19 of 24 patients (76%) after PED for pyogenic spondylitis. The remaining five patients failed to achieve infection control by PED. One such patient was not able to control the infection after PED, and another patient developed an epidural abscess 2 weeks after PED. Remaining three "failed" patients had exacerbations of their infections during the postoperative course and required additional surgery. Univariate analyses demonstrated that diabetes mellitus (DM; p = 0.05), hemodialysis due to DM-induced renal failure (p = 0.02), concomitant malignant disease (p = 0.09), and acute onset (p = 0.05) were possibly correlated with PED failure. Stepwise logistic regression analysis revealed that hemodialysis due to DM-induced renal failure was an independent factor associated with PED failure (p = 0.03). CONCLUSIONS: PED might be considered as one of the alternative therapeutic options before invasive radical surgeries for pyogenic spondylitis after failure of standard conservative therapy. Even by less invasive PED, pyogenic spondylitis patients with DM-hemodialysis showed poor outcome.


Assuntos
Discotomia/métodos , Endoscopia/métodos , Vértebras Lombares , Abscesso do Psoas/complicações , Espondilite/cirurgia , Idoso , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Abscesso do Psoas/microbiologia , Abscesso do Psoas/cirurgia , Radiografia , Espondilite/etiologia , Resultado do Tratamento
6.
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
7.
Rev Assoc Med Bras (1992) ; 65(5): 678-681, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31166445

RESUMO

OBJECTIVE: We describe the case of a diabetic patient who developed vertebral osteomyelitis and bilateral psoas abscess with gas formation due to klebsiella pneumoniae. METHODS: A 64-year-old woman with a 4-year history of type-2 diabetes mellitus was admitted to the Emergency Department. The subject had a 2-day history of high-grade fever associated with chills and a 5-hour history of consciousness. She received empirical treatment with febrifuge, after which her fever decreased. RESULTS: Her fever recurred after an interval of three hours. A computed tomography scan of the abdomen revealed vertebral osteomyelitis and bilateral psoas muscle abscess with gas formation. Blood culture and purulent fluid described the growth of the Klebsiella pneumoniae. The patient received antibiotic therapy and bilateral drainage therapy after the drainage catheter was placed into the abscess cavity by CT-guidance. Due to the serious damage to the vertebral column and permanent pain, the patient underwent minimally invasive internal spinal fixation and recovered successfully. CONCLUSION: A case of vertebral osteomyelitis and bilateral psoas abscess with gas formation caused by Klebsiella pneumoniae in a diabetic patient. Antibiotic therapy, drainage, and minimally invasive internal spinal fixation were performed, which enabled a good outcome.


Assuntos
Complicações do Diabetes/cirurgia , Infecções por Klebsiella/cirurgia , Klebsiella pneumoniae/patogenicidade , Osteomielite/cirurgia , Abscesso do Psoas/cirurgia , Doenças da Coluna Vertebral/cirurgia , Complicações do Diabetes/microbiologia , Drenagem/métodos , Feminino , Gases/metabolismo , Humanos , Infecções por Klebsiella/microbiologia , Pessoa de Meia-Idade , Osteomielite/microbiologia , Abscesso do Psoas/microbiologia , Reprodutibilidade dos Testes , Doenças da Coluna Vertebral/microbiologia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
8.
J Coll Physicians Surg Pak ; 29(6): S45-S47, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31142419

RESUMO

Iliopsoas abscess (IPA) is rare in children but exceptional in neonates. Fewer than 30 cases have been reported in literature. We present a case of 11-day neonate who was brought with left inguinal swelling along with significantly raised white cell count and positive C-reactive protein (CRP). Ultrasound and CT scan confirmed the diagnosis of IPA. Drainage of abscess was done by open method through extraperitoneal approach. Systemic antibiotics, according to culture and sensitivity, were given and the neonate recovered well and was sent home. IPA can be primary or secondary. Primary IPA is more common in neonates unlike adults, who have secondary IPA in majority of the cases. Primary IPA spreads by hematogenous route from distant occult source in the body. Staphylococcus aureus is the causative organism in most cases of primary IPA. Septic arthritis of hip joint is among important differentials. Ultrasound and CT scan are helpful in diagnosis in the presence of raised white cell count and positive CRP. Drainage of pus by open method and through extraperitoneal approach is preferred method although ultrasound-guided percutaneous drainage has also been done with successful outcome. In conclusion, neonatal IPA is extremely rare entity and can easily be overlooked. High index of suspicion is required for its diagnosis in cases where a neonate presents with groin swelling, limited or painful motion of leg and fever.


Assuntos
Antibacterianos/uso terapêutico , Linezolida/uso terapêutico , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Abscesso do Psoas/diagnóstico , Abscesso do Psoas/terapia , Infecções Estafilocócicas/diagnóstico , Administração Intravenosa , Proteína C-Reativa/metabolismo , Drenagem/métodos , Feminino , Febre/complicações , Humanos , Recém-Nascido , Abscesso do Psoas/microbiologia , Infecções Estafilocócicas/tratamento farmacológico , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Ultrassonografia
9.
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
10.
Ther Apher Dial ; 23(6): 534-541, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30864296

RESUMO

Iliopsoas abscess in HD patients is rare. We examined nine HD patients with iliopsoas abscess (six men and five diabetes mellitus cases) treated between 2005 and 2015. Mean age and dialysis vintage at onset were 72 years and 109 months, respectively. Of the nine patients, four had lumbar orthopedic diseases, and two had all components of the classic triad of iliopsoas abscess at onset. All nine patients underwent percutaneous drainage, while seven underwent antimicrobial therapy. The most common pathogenic bacterium was methicillin-resistantStaphylococcus aureus(MRSA) (n = 5). Four patients had multilocular recurrence on the same side as the initial abscess and did not undergo CT before drainage catheter removal. Five patients died in the hospital, in which three died due to infectious diseases by MRSA. We suggest percutaneous drainage as the first-line therapy for HD patients with iliopsoas abscess and recommend combining antimicrobial therapy for MRSA, because of poor prognosis.


Assuntos
Falência Renal Crônica/terapia , Abscesso do Psoas/terapia , Diálise Renal , Infecções Estafilocócicas/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/administração & dosagem , Drenagem/métodos , Feminino , Humanos , Masculino , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Pessoa de Meia-Idade , Abscesso do Psoas/microbiologia , Estudos Retrospectivos , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/terapia
13.
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
15.
Ann Biol Clin (Paris) ; 76(5): 571-573, 2018 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-30154067

RESUMO

Psoas abscess is a rare infection, difficult to diagnose, which can be primary or secondary, it is often caused by a bacterial micro-organism (Staphylococcus aureus, Escherichia coli), and in rare cases by a fungal micro-organism (Candida). We report an exceptional case of Candida tropicalis psoas abscess in a 52-year-old man with no history of pathology who had inflammatory lower back pain with fever and general deterioration. The biological assessment showed a renal insufficiency and a biological inflammatory syndrome, a computed tomography made in urgency was in favor of a psoas abscess. The bacteriological study of percutaneous drainage product allowed to isolate Candida tropicalis.


Assuntos
Candida tropicalis/isolamento & purificação , Candidíase/diagnóstico , Abscesso do Psoas/diagnóstico , Abscesso do Psoas/microbiologia , Candidíase/microbiologia , Humanos , Dor Lombar/etiologia , Dor Lombar/microbiologia , Masculino , Pessoa de Meia-Idade , Insuficiência Renal/complicações , Insuficiência Renal/microbiologia , Síndrome de Resposta Inflamatória Sistêmica/diagnóstico , Síndrome de Resposta Inflamatória Sistêmica/microbiologia
17.
BMC Surg ; 18(1): 16, 2018 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-29534714

RESUMO

BACKGROUND: Here we report a rare case of lumbar spine epidural abscess and facet joint septic arthritis caused by Streptococcus agalactiae, which had spread to the iliopsoas muscles, leading to urine retention. CASE PRESENTATION: A 68-year-old woman with low back pain experienced a sudden onset of bilateral lower limb weakness, it was followed 14 days later by urine retention. At consultation, magnetic resonance imaging and identification of serum ß-hemolytic streptococci provided a diagnosis of Streptococcus agalactiae infection. She was started on antibiotics. Despite diminishing signs of inflammation, preoperative MRI showed an epidural mass at T12-L4 compressing the cord and involving the paravertebral muscles as well. Group B beta-hemolytic streptococci were detected in both urine and blood. Because of bilateral lower limb weakness and urine retention, T12-L4 hemilaminectomy was performed. The L3/L4 intertransverse ligament resected and abscess drained. Histopathology revealed that inflammatory cells had invaded the facet joint. Group B beta-hemolytic streptococci were identified, confirming the diagnosis. The patient continued with the antibiotics postoperatively, and her health rapidly improved. CONCLUSION: Lumbar spine epidural abscess and facet joint septic arthritis caused by Streptococcus agalactiae is a clinical emergency, with significant morbidity and mortality especially with delayed diagnosis. A delay in both diagnosis and aggressive treatment can lead to not only severe neurological deficit but also to septicaemia, multiorgan failure, and even death.


Assuntos
Artrite Infecciosa/microbiologia , Abscesso Epidural/microbiologia , Vértebras Lombares/microbiologia , Infecções Estreptocócicas/microbiologia , Streptococcus agalactiae/isolamento & purificação , Articulação Zigapofisária/microbiologia , Idoso , Antibacterianos/uso terapêutico , Artrite Infecciosa/diagnóstico por imagem , Artrite Infecciosa/terapia , Abscesso Epidural/diagnóstico por imagem , Abscesso Epidural/terapia , Feminino , Humanos , Dor Lombar/etiologia , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Imagem por Ressonância Magnética , Abscesso do Psoas/diagnóstico por imagem , Abscesso do Psoas/microbiologia , Abscesso do Psoas/terapia , Doenças da Coluna Vertebral/diagnóstico por imagem , Doenças da Coluna Vertebral/microbiologia , Doenças da Coluna Vertebral/terapia , Infecções Estreptocócicas/terapia , Retenção Urinária/etiologia , Articulação Zigapofisária/diagnóstico por imagem , Articulação Zigapofisária/cirurgia
18.
Drug Discov Ther ; 12(1): 47-50, 2018 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-29479049

RESUMO

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.


Assuntos
Infecções por Escherichia coli/diagnóstico , Abscesso do Psoas/microbiologia , Infecções Estafilocócicas/diagnóstico , Vancomicina/administração & dosagem , Administração Intravenosa , Adolescente , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Abscesso do Psoas/diagnóstico por imagem , Abscesso do Psoas/tratamento farmacológico , Infecções Estafilocócicas/tratamento farmacológico , Staphylococcus aureus/isolamento & purificação , Resultado do Tratamento , Vancomicina/uso terapêutico
20.
Asian J Surg ; 41(2): 131-135, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27938929

RESUMO

OBJECTIVES: Thai aims of this study were to provide an epidemiological and microbiological analysis of psoas abscess in the human immunodeficiency virus (HIV)-infected population, and to describe the optimal investigative and management approach of this condition. METHODS: A retrospective chart analysis of 20 patients with a diagnosis of psoas abscess admitted to a regional academic hospital from January 2012 to December 2014 was performed. RESULTS: Twenty patients with psoas abscess were identified, of which 14 were HIV positive (70%) and five HIV negative (25%). One patient remained untested (5%). The mean CD4 count was 402 cells/mL (range 150-796 cells/mL, median 367 cells/mL). Acid fast bacilli were positive in psoas abscess aspirates in 13 cases (65%). Staphylococcus aureus and Escherichia coli were identified in 15% of cases. The radioisotope bone scan showed increased vertebral uptake in 10 patients (62.5%), with the lumbar spine (L1-L4) being most commonly involved (31%). There was a statistically significant increase in radioisotope uptake in the lumbar vertebrae in tuberculous psoas abscess than in pyogenic psoas abscess (p=0.003). Ultrasound-guided percutaneous drainage was used in 16 patients (80%) with a success rate of 87.5%; only two cases required repeat drainage (12.5%). Open drainage was used in four patients (30%) with a 100% success rate. There were no mortalities at 30-day follow-up. CONCLUSION: Tuberculous psoas abscess from underlying vertebral osteomyelitis is more common than pyogenic psoas abscess. Ultrasound has high diagnostic accuracy and guides percutaneous drainage with excellent success rates. Ultrasound-guided percutaneous drainage should be regarded as the first-line therapeutic modality.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Infecções por HIV/epidemiologia , Abscesso do Psoas/epidemiologia , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/cirurgia , Cirurgia Assistida por Computador/métodos , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/cirurgia , Adulto , Idoso , Terapia Antirretroviral de Alta Atividade/métodos , Estudos de Coortes , Comorbidade , Drenagem/métodos , Feminino , Seguimentos , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Abscesso do Psoas/diagnóstico por imagem , Abscesso do Psoas/microbiologia , Abscesso do Psoas/cirurgia , Estudos Retrospectivos , Medição de Risco , África do Sul/epidemiologia , Infecções Estafilocócicas/diagnóstico , Resultado do Tratamento , Ultrassonografia de Intervenção , Adulto Jovem
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