Case of acute paraspinal pyomyositis in an elderly diabetic secondary to spread from urinary tract infection

Unnikrishnan, Dileep; Delacruz, Maria Amanda; Saha, Anamika; Daniels, Richard

doi:10.1136/bcr-2018-225739

Cited by 4 publications

(3 citation statements)

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“…reported an elderly woman with diabetes and psoas/paraspinal muscle abscesses secondary to a urinary infection. [ 8 ] Kiymaz and Demir reported a child with very large paraspinal and epidural abscesses attributed to a localized streptococcal skin infection of the neck. [ 4 ] Here, a 31-year-old male with a localized L3-L4 level PV skin lesion developed an infection involving the right paraspinal muscles, the right L34 facet, and spinal epidural compartment (i.e., abscess) that required operative decompression/resection and appropriate follow-up antibiotic therapy for MSSA.…”

Section: Discussionmentioning

confidence: 99%

Psoriasis vulgaris of the skin caused a L3-L4 lumbar epidural spinal abscess

Nakamura,

Ninomiya,

Ishihara

et al. 2024

Surgical Neurology International

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Background: In a 31-year-old male, psoriasis vulgaris (PV) of the skin caused paraparesis attributed to a L3-L4 epidural spinal abscess that required emergent surgical decompression. Case Description: A 31-year-old male presented with lower back pain and cauda equina compression attributed to a magnetic resonance-documented L34 enhancing lesion consistent with a spinal epidural abscess (SEA). The skin over the L3-L4 level revealed severe PV that proved to be the likely etiology of the right-sided paraspinal muscle abscess, infected right L3-L4 facet joint, and SEA. At surgery, the foci of infection were excised/decompressed, and cultures grew methicillin-susceptible Staphylococcus aureus. Following surgery, the patient was improved and was treated with appropriate antibiotic therapy. Conclusion: PV caused a L3-L4 epidural spinal abscess and cauda equina compression in a 31-year-old male who was successfully treated with operative decompression and appropriate antibiotic management.

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Section: Discussionmentioning

confidence: 99%

Psoriasis vulgaris of the skin caused a L3-L4 lumbar epidural spinal abscess

Nakamura,

Ninomiya,

Ishihara

et al. 2024

Surgical Neurology International

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“…There have been reported cases of Staphylococcal bacteria-related paraspinal pyomyositis occurring in the setting of a urinary tract infection: these have been in patients who also have diabetes mellitus [ 9 , 10 ]. The blood culture sample from our patient did not yield any bacteria.…”

Section: Discussionmentioning

confidence: 99%

Pyomyositis Affecting the Paraspinal and Iliacus Muscles in a Patient With Staphylococcus aureus Urinary Tract Infection

Javed

Kamara

Oyibo

2021

Cureus

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We report a case of a 63-year-old man who presented with a four-day history of fever, night sweats, and left lower back pain, which radiated down to his left buttock and leg. He also had a short-lived episode of chest pain and breathlessness. He had a medical history of chronic back pain, which had been diagnosed as sciatica three years ago. Initial investigations revealed raised inflammatory markers due to a Staphylococcus aureus urinary tract infection. Despite treatment, his inflammatory markers did not improve and the left lower back pain persisted. A magnetic resonance imaging scan demonstrated features consistent with pyomyositis of the left lumbar erector spinae (paraspinal) and iliacus muscles. After prolonged antibiotic therapy, his symptoms completely resolved. Pyomyositis is a rare tropical infection of the skeletal muscles most commonly caused by Staphylococcus aureus . Risk factors include trauma and immunosuppression. This case highlights a nearly missed diagnosis of paraspinal and iliacus pyomyositis in patients with a background history of chronic lower back pain. Early diagnosis and treatment are pivotal in preventing serious complications such as septicemia and multi-organ failure.

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“…UTI caused by GBS are also common in pregnant, diabetic, and immunocompromised individuals, as well as those with pre‐existing urologic abnormalities, wherein there is a higher risk of ascending pyelonephritis with potential to progress to bacteremia and/or urosepsis 5,7‐9 . At times, other severe complications like massive abdominopelvic abscess 10 and acute paraspinal myositis 11 have also been described in diabetic patients secondary to cystitis due to GBS.…”

Section: Introductionmentioning

confidence: 99%