The iliopsoas abscess: aetiology, therapy, and outcome

Baier, P.; Arampatzis, G.; Imdahl, A.; Hopt, Ulrich T.

doi:10.1007/s00423-006-0052-6

Cited by 31 publications

(32 citation statements)

References 18 publications

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“…Primary psoas abscesses appear to have a better prognosis, with a mortality rate as low as 2%; secondary psoas abscesses have a mortality of approximately 20% (91). Factors predicting mortality in one study included age, APACHE score, bilateral abscesses, and postoperative or bony cause (15).…”

Section: Psoas Abscessmentioning

confidence: 99%

“…Surgical drainage and intravenous antibiotics are recommended, similar to pyomyositis. Drainage may involve either CT-guided percutaneous drainage or an open surgical procedure; the choice often depends on the number and volume of the abscesses (15). For example, some experts suggest that cases of multiloculated psoas abscesses are best managed with an open surgical procedure via an extraperitoneal approach (14,15,155).…”

Section: Psoas Abscessmentioning

confidence: 99%

“…Drainage may involve either CT-guided percutaneous drainage or an open surgical procedure; the choice often depends on the number and volume of the abscesses (15). For example, some experts suggest that cases of multiloculated psoas abscesses are best managed with an open surgical procedure via an extraperitoneal approach (14,15,155). Open surgical drainage may be preferentially utilized in cases of secondary psoas abscesses where there is concurrent gastrointestinal or genitourinary disease requiring surgical management.…”

Section: Psoas Abscessmentioning

confidence: 99%

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Bacterial, Fungal, Parasitic, and Viral Myositis

2008

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SUMMARY Infectious myositis may be caused by a broad range of bacterial, fungal, parasitic, and viral agents. Infectious myositis is overall uncommon given the relative resistance of the musculature to infection. For example, inciting events, including trauma, surgery, or the presence of foreign bodies or devitalized tissue, are often present in cases of bacterial myositis. Bacterial causes are categorized by clinical presentation, anatomic location, and causative organisms into the categories of pyomyositis, psoas abscess, Staphylococcus aureus myositis, group A streptococcal necrotizing myositis, group B streptococcal myositis, clostridial gas gangrene, and nonclostridial myositis. Fungal myositis is rare and usually occurs among immunocompromised hosts. Parasitic myositis is most commonly a result of trichinosis or cystericercosis, but other protozoa or helminths may be involved. A parasitic cause of myositis is suggested by the travel history and presence of eosinophilia. Viruses may cause diffuse muscle involvement with clinical manifestations, such as benign acute myositis (most commonly due to influenza virus), pleurodynia (coxsackievirus B), acute rhabdomyolysis, or an immune-mediated polymyositis. The diagnosis of myositis is suggested by the clinical picture and radiologic imaging, and the etiologic agent is confirmed by microbiologic or serologic testing. Therapy is based on the clinical presentation and the underlying pathogen.

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Section: Psoas Abscessmentioning

confidence: 99%

Section: Psoas Abscessmentioning

confidence: 99%

Section: Psoas Abscessmentioning

confidence: 99%

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Bacterial, Fungal, Parasitic, and Viral Myositis

2008

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“…11 Mortality rates from psoas abscess were 15% in one large study. 12 The poor prognostic indicators identified by this study were age, bilateral psoas abscess, a bony or postoperative source, and high acute physiology and chronic health evaluation II score.…”

Section: Long Answermentioning

confidence: 74%

A sinister cause of back pain in a young man

O’Keeffe

Terris

Hormbrey

2012

BMJ

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“…It occurs especially in immunocompromised patients (e.g., treated with steroid and with diabetes mellitus) [1]. Especially in primary psoas abscess, Staphylococci are the most common bacteria [2,3]. On primary psoas abscess, the fascia of iliopsoas usually prevents spreading of abscess to retroperitoneal and free peritoneal space.…”

Section: Discussionmentioning

confidence: 98%

Psoas abscess and bacterial peritonitis caused by urinary tract infection in a patient of liver cirrhosis and diabetes mellitus

Kamikado

Taguchi

Wakiyama

et al. 2009

Clin J Gastroenterol

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Prognosis of patients with diabetes mellitus or liver cirrhosis can be worsened by the development of a variety of infectious diseases. We describe a case of psoas abscess and bacterial peritonitis in a 58-year-old woman with type C liver cirrhosis and diabetes mellitus hospitalized after having an elevated temperature caused by urinary tract infection for 2 months. The cirrhosis had not been treated and daily self-administration of insulin had been discontinued for the previous 5 months. On day 2 of hospitalization, vomiting and decreased blood pressure developed. Abdominal computed tomography scan revealed ascites, pneumoperitoneum, and psoas abscess. Laparotomy revealed psoas abscess and bacterial peritonitis without gastrointestinal perforation and psoas abscess perforation. Surgical drainage of the abscess and peritoneal cavity was performed. Immediately after the operation, upper gastrointestinal bleeding, shock, hypoglycemia, and metabolic acidosis developed, followed by hepatic failure, renal insufficiency, and cerebral dysfunction. Death occurred on postoperative day 19. Upon autopsy, bacterial peritonitis residue of psoas abscess, and urinary tract infection were confirmed. We surmise that untreated liver cirrhosis and diabetes mellitus is a risk for urinary tract infection that may spread in iliopsoas and free peritoneal space.

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The iliopsoas abscess: aetiology, therapy, and outcome

Abstract: We suggest an algorithm for treatment of iliopsoas abscesses depending on number and volume of the abscesses.

Cited by 31 publications

References 18 publications

Bacterial, Fungal, Parasitic, and Viral Myositis

Bacterial, Fungal, Parasitic, and Viral Myositis

A sinister cause of back pain in a young man

Psoas abscess and bacterial peritonitis caused by urinary tract infection in a patient of liver cirrhosis and diabetes mellitus

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