Absceso retroperitoneal secundario a espondilodiscitis tuberculosa simulando una hernia inguinal incarcerada.

Tuberculosis is the commonest cause of spinal infection worldwide (9-46%). Tuberculosis spondylodiscitis causes multifocal thoracic and lumbar spinal disease, and big paraspinal and psoas abscesses. It is more frequent in people under 40 who had previous tuberculosis infection and from countries where the illness is endemic. Clinic is non-specific and sub-acute. We report the clinical case of a 29-year-old patient who suffered from pericardic tuberculosis in her childhood and who presents a bilateral retroperitoneal abscess due to tuberculosis spondylodiscitis. Her clinical debut began with left inguinal pain and an irreducible mass at this level that simulated an incarcerated inguinal hernia, which is why surgery was indicated. Due to discrepancies between intraoperative findings and the initial diagnosis, the diagnosis and treatment strategy were changed. The purpose of this case report is to emphasize the challenge that the diagnosis of this pathology represents, due to low incidence in our environment and poor clinical features, which results in late diagnosis and late management.

[Buschke-Lowenstein Tumor associated to nasopharyngeal condillomatosis]. / Tumor de Buschke-Lowenstein asociado a condilomatosis nasofaríngea.

Giant Acuminata Condyloma or Buschke-Lowenstein Tumor (BLT) is a rare disease characterized typically by its perineal location, local aggressiveness and its cauliflower-like aspect. BLT is associated with Human Papilloma Virus (HPV) infection. Because malignant transformation of BLT is high, radical local excision and histopathological examination are needed. We report a 26-year-old male, seropositive for HIV with giant verrucous lesions in the inguinal, perineal, suprapubic and genital area. Rectosismoidoscopy revealed anal canal involvement. Oropharyngeal papillomatosis was also found. Wide local excision was performed, including inguinoperineal and oropharyngeal lesions. Pathology studies show papillomatosis with koilocytes and no evidence of malignant transformation.

Psoas abscess due to Pasteurella multocida.

Psoas abscess is a pus collection within the muscle compartment. It is a very uncommon entity. It can be primary as a result of haematogenous spread or secondary as a consequence of a direct extension of an infectious focus. Diagnosis is usually delayed because nonspecific clinical presentation. Staphylococcus aureus is the most common organism cultured in this type of abscess. We describe a secondary psoas abscess in an elderly female patient. The patient presented with fever, right groin pain and malaise. Following laboratory, radiological and microbiological analyses the patient was diagnosed as having a psoas abscess due to Pasteurella multocida, which is a Gram negative bacteria, part of the normal oral flora of many animals and can causes human infections after animal scratches or bites. More rarely is to find this organism causing psoas abscesses. Because of insidious clinical presentation, the diagnosis of psoas abscess is a challenge and a high index of suspicion is required. We emphasize the importance of bacteriological confirmation of microorganism involved to choose the correct antibiotics. Percutaneous drainage is the treatment of choice. Open surgical drainage should be reserved if percutaneous drainage fails.