Bilateral Primary Brucellar Psoas Abscess

Balagué, Federico; Waldburger, Martin

doi:10.1093/rheumatology/33.10.988

Cited by 13 publications

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“…El Hassani reported two cases with strongly positive Brucella agglutination test with psoas abscess, but, as blood cultures were negative for brucella, those cases need more strong evidation (3). The other three cases that could be reached with proven brucellosis reports belong to Torres‐Rojas (7), Jayakumar (6) and Dudler J (12) from Switzerland. Torres‐Rojas reported a case of severe chronic spondylitis of the lumbar spine with a large left psoas abscess caused by Brucella abortus .…”

Section: Discussionmentioning

confidence: 99%

Primary brucellar psoas abscess: presentation of a rare case of psoas abscess caused by Brucella melitensis without any osteoarticular involvement

Gündeş

Gundes

Şarlak

et al. 2004

International Journal of Clinical Practice

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The psoas abscess is an entity, sometimes forgotten in our daily practice, because of infrequency and difficulties in diagnosis. Primary psoas abscess is very rare and grampositive micro-organisms account for more than 80% of the cases. Our case, a 62-year-old man was admitted with a 5-year history of back pain and fever. Physical examination was normal, except a palpable hepatomegaly with a mild tenderness over his lower right abdominal quadrant. The Brucella agglutination test was strongly positive with a titre of 1/640, as Rose Bengal Spot test. Blood cultures for brucella were positive on the fourth day and became negative, as the specific therapy started. Further examination with ultrasonography and computed tomography revealed an abscess of 40 1 75 mm in the psoas muscle. Complete resolution of symptoms achieved within 6 weeks. Although clinical presentation of psoas abscesses is often similar and non-specific, early aetiological diagnosis is extremely important, because of high achievement with appropriate antibiotic regimens. Brucellar psoas abscess seems very rare even in Turkey, where Brucella is still highly endemic. Such a case has not been previously reported from Turkey, as far as we know.Most psoas abscesses are secondary. They occur when infection follows extension from an adjacent focus, mainly bone, genitourinary or intestinal tracts. In European countries, intestinal micro-organisms are the major causative agents, whereas Mycobacterium tuberculosis is the most common organism in Turkey (1).Primary psoas abscess is an infrequent disease of difficult diagnosis, which occurs after direct inoculation or haematogenous spread from distant foci. Numerous micro-organisms have been reported to be isolated, but Staphylococcus aureus accounts for more than 80% of primary cases (2). Other causative micro-organisms including Brucella are found to be very rare. Although a literature review revealed eight cases of Brucellar psoas abscess, only three of them were in English literature (3-9). To our knowledge, such a case has not been previously reported from Turkey. C A S E R E P O R TOur case, a 62-year-old man was admitted with a 5-year history of fever and back pain, in which symptoms was developed gradually. He had malaise, weight loss, anorexia and nocturnal pyrexia, accompanying with chills. His past medical history was normal. He had no contact with infected animals. He lived in an urban city and had no history of ingestion of contaminated dairy products such as fresh milk and cheese, which is known to be the most common cause of transmission in our country. On admission, he had a fever of 39.3˚C with stable vital signs. Physical examination was normal, except a palpable hepatomegaly with a mild tenderness over his lower right abdominal quadrant. Routine haemogram revealed a mild leukocytosis of 10,200 cells/ml. The erythrocyte sedimentation rate was normal. Brucella agglutination test was strongly positive with a serum agglutination test titre of 1 : 640. Other routine laboratory investigations were no...

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Section: Discussionmentioning

confidence: 99%

Primary brucellar psoas abscess: presentation of a rare case of psoas abscess caused by Brucella melitensis without any osteoarticular involvement

Gündeş

Gundes

Şarlak

et al. 2004

International Journal of Clinical Practice

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“…The other aspect of note in the present case was that multiple abscesses occurred simultaneously in the psoas, piriformis and gluteal muscles in a patient without predisposing diseases or trauma. A psoas abscess with multiple muscle abscesses is rare, even with predisposing factors; only one case has been reported previously 6 . Abscesses in piriformis or gluteal muscles are also rare 6 –10 .…”

Section: Discussionmentioning

confidence: 99%

“…A psoas abscess with multiple muscle abscesses is rare, even with predisposing factors; only one case has been reported previously 6 . Abscesses in piriformis or gluteal muscles are also rare 6 –10 . Although a secondary abscess caused by direct extension through the sciatic notch from the psoas abscess cannot be ruled out, we speculate that the piriformis and gluteal abscesses, as well as psoas abscesses, were primary abscesses with an unknown origin of infection.…”

Section: Discussionmentioning

confidence: 99%

“…6 Abscesses in piriformis or gluteal muscles are also rare. [6][7][8][9][10] Although a secondary abscess caused by direct extension through the sciatic notch from the psoas abscess cannot be ruled out, we speculate that the piriformis and gluteal abscesses, as well as psoas abscesses, were primary abscesses with an unknown origin of infection. We chose surgical drainage to treat the abscesses because we thought it more reliable than CT-or ultrasound-guided drainage, despite its invasiveness.…”

Section: Discussionmentioning

confidence: 99%

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Psoas abscess associated with iliac vein thrombosis and piriformis and gluteal abscesses

et al. 1999

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Background: A 14-year-old boy was admitted because of lumbago and high fever. Methods/Results: Computed tomography scans revealed psoas, piriformis and gluteal abscesses as well as right iliac vein thrombus. A right femoral venogram demonstrated compression from the psoas abscess and thrombosis of the common iliac vein. Appropriate surgical drainage, administration of antibiotics and anticoagulant therapy were effective in the present case. Conclusions: This is the first report of primary psoas abscess associated with vein thrombosis and is also unique in that abscesses were multiple without predisposing diseases or trauma.

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“…La forma osteoarticular representa el 25-40% de formas localizadas y suele hacerlo como sacroileitis en jóvenes y espondilodiscitis lumbar en edad más avanzada [5][6][7] . La manifestación clínica más frecuente en estos casos consiste en impotencia funcional, ciatalgia de distribución S1, do-lor abdominal y en ocasiones cuadro abigarrado que puede provocar la realización de una laparotomía exploradora.…”

Section: Figura 2 Absceso De Psoas Bilateral Corte Sagitalunclassified

Absceso de psoas brucelósico bilateral: presentación de un caso y revisión de la literatura

et al. 2005

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La brucelosis es una zoonosis poco frecuente, aunque es endémica en España. Suele manifestarse como una enfermedad sistémica con presentación aguda o crónica, en ocasiones lo hace de manera localizada afectando a uno o varios aparatos. La presentación focal más frecuente es la forma osteoarticular. Ésta se puede complicar en ocasiones con abscesos para-perivertebrales, la afectación del psoas unilateral es rara y en casos excepcionales existe extensión a ambos músculos bilateralmente. Las manifestaciones clínicas de los abscesos de psoas(AP) suelen ser insidiosas, es infrecuente la aparición de la triada clásica de fiebre, dolor lumbar e impotencia funcional. Para el diagnóstico son necesarias las pruebas serológicas y medios de cultivo. El uso extendido de la Ecografía (ECO) y la Tomografía Axial Computerizada (TAC) ha mejorado el diagnóstico y tratamiento de las complicaciones. El tratamiento de elección es antibiótico y se basa en el uso de tetraciclinas y estreptomicina. En ocasiones se hace necesaria la punción percutánea o drenaje abierto de los abscesos. Presentamos un caso de AP brucelósico bilateral y revisamos la bibliografía.

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Bilateral Primary Brucellar Psoas Abscess

Cited by 13 publications

References 0 publications

Primary brucellar psoas abscess: presentation of a rare case of psoas abscess caused by Brucella melitensis without any osteoarticular involvement

Primary brucellar psoas abscess: presentation of a rare case of psoas abscess caused by Brucella melitensis without any osteoarticular involvement

Psoas abscess associated with iliac vein thrombosis and piriformis and gluteal abscesses

Absceso de psoas brucelósico bilateral: presentación de un caso y revisión de la literatura

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