Clostridial myositis of the psoas complicating percutaneous nephrostomy

Wells, A D; Fletcher, M. S.; Teare, E.L.; Walters, Huw; Yates-Bell, A. J.

doi:10.1002/bjs.1800720727

Cited by 7 publications

(3 citation statements)

References 2 publications

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“…[11] Mycobacterium tuberculosis as a cause of IPA is currently uncommon in the western world, but common in the developing countries. [3] The other causative organisms include Proteus,[12] Bacteroides,[13] Clostridia,[14] Klebsiella,[15] methicillin-resistant Staphylococcus aureus ,[16] and non-tuberculosis mycobacteria. [1718]…”

Section: Discussionmentioning

confidence: 99%

Clinical manifestations and prognostic factor of iliopsoas abscess

Asai

Ohkuni

Yamazaki

et al. 2013

J Global Infect Dis

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Introduction:Iliopsoas abscess (IPA) is a collection of pus in the iliopsoas compartment, which is considered rare in Japan. However, the number of patients with IPA has recently increased among the elderly or compromised hosts.Subjects and Methods:This retrospective study aims to examine the clinical pictures, pathological findings, and the prognostic factor of IPA. We analyzed all patients with IPA who were admitted to our hospital from April 2006 to July 2011. Patients’ characteristics, treatment, clinical outcome, radiological findings, bacteria isolated, and comorbidities were evaluated. The comorbidities were evaluated by the Charlson comorbidity index (CCI). We compared the survival and non-survival groups to assess the prognostic factors of IPA.Results:A total of 33 patients were enrolled in this study, which included 14 males and 19 females. The mean age of the patients was 71.5 years (range 32-92 years). The most common underlying disease was spinal disease (16 of 33, 48.5%). Twenty-nine patients (87.9%) were cured and four patients (12.1%) died. While 12 patients (36.4%) were initially treated conservatively with antibiotics alone, percutaneous drainage was performed initially in 19 patients (57.6%). Two patients (6%) directly underwent exploratory surgery and open drainage. In terms of patients’ characteristics, there were no significant differences in either group. The score of CCI in non-survivors was higher than that in survivors (1.38 vs. 5.5, P < 0.001).Conclusions:The epidemiology of IPA is quite different from what it used to be. CCI appears to be useful in evaluating the patients’ prognosis with IPA.

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Section: Discussionmentioning

confidence: 99%

Clinical manifestations and prognostic factor of iliopsoas abscess

Asai

Ohkuni

Yamazaki

et al. 2013

J Global Infect Dis

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“…clostridium,16 Yersinia enterocolitica, 17 klebsiella,18 methicillin resistant Staphylococcus aureus, 19 salmonella,20 Mycobacterium kansasii,21 and Mycobacterium xenopi 22. …”

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confidence: 99%

Iliopsoas abscesses

Mallick

Thoufeeq

Rajendran

2004

Postgraduate Medical Journal

244

338

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“…Myonecrosis may also concern the thoracic wall [92]. Focal clostridial myositis affecting the psoas muscle has been reported as a complication of a percutaneous nephrostomy [93]. In a single case general gas gangrene after cholecystectomy and drainage of a hepatic abscess was associated with severe rhabdomyolysis [94].…”

Section: Myositis Fasciitis and Rhabdomyolysismentioning

confidence: 99%

Neuromuscular and Central Nervous System Manifestations of Clostridium perfringens Infections

Finsterer

Hess

2007

Infection

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Infections with Clostridium perfringens usually manifest locally or spread to sepsis with multiorgan involvement, hemolysis or septic shock. Central nervous system (CNS) manifestations are rare and most frequently comprise meningitis with or without pneumencephalon, encephalitis, plexitis, cerebral abscess, or subdural empyema. The course of CNS affections is usually foudroyant and the outcome fatal. Neuromuscular manifestations of C. perfringens infections are much more frequent than CNS manifestations and comprise myonecrosis (gas gangrene), rhabdomyolysis, myositis, fasciitis, affection of the neuromuscular transmission, or affection of the peripheral nerves. C. perfringens infections usually start from the site of a recent surgical wound or trauma, a gastrointestinal or urogenital problem, or occur in association with malignancy. In quite a number of cases the source of origin remains speculative. Treatment of choice is surgical debridement of the infectious focus with radical removal of all necrotic tissue, resection of the corresponding lymphatics in addition to antibiotic therapy with penicillin G, aminoglycosides, or clindamycin or hyperbaric oxygenation. Despite these therapeutic options, the prognosis of CNS and neuromuscular involvement in an infection with C. perfringens is still poor. Only focal infections or clostridial brain abscesses may eventually have a more favorable outcome, if surgery and antibiotics are instantly provided. Generally, early recognition of the infectious agent is of paramount importance to prevent from spreading and the development of severe hemolysis, septic shock, or death.

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Clostridial myositis of the psoas complicating percutaneous nephrostomy

Cited by 7 publications

References 2 publications

Clinical manifestations and prognostic factor of iliopsoas abscess

Clinical manifestations and prognostic factor of iliopsoas abscess

Iliopsoas abscesses

Neuromuscular and Central Nervous System Manifestations of Clostridium perfringens Infections

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