Iliopsoas abscess as a complication of tunneled jugular vein catheterization in a hemodialysis patient

Abstract

Iliopsoas abscess is a rare complication in hemodialysis patients that is mainly due to adjacent catheterization, local acupuncture, discitis, and bacteremia. Herein, we report a 47-year-old woman undergoing regular hemodialysis via a catheter in the internal jugular vein who presented with low back pain and dyspnea. A heart murmur suggested the presence of catheter-related endocarditis, and this was confirmed by an echocardiogram and a blood culture of methicillin-resistant Staphylococcus aureus. A computed tomography indicated a pulmonary embolism and an incidental finding of iliopsoas abscess. Following surgical intervention and intravenous daptomycin, the patient experienced full recovery and a return to usual activities. This case indicates that an iliopsoas abscess can be related to a jugular vein catheter, which is apparently facilitated by infective endocarditis. The possibility of iliopsoas abscess should be considered when a hemodialysis patient presents with severe low back pain, even when there is no history of adjacent mechanical intervention.

Bacterial meningitis and multiple abscess formation in the iliopsoas, erector spinae, and vastus lateralis muscle in a maintenance hemodialysis patient treated with continuous epidural anesthesia for herpes zoster-related pain control: a case report and review of the literature

“…Most cases are treated with combination of intravenous antibiotics treatment and surgical drainage, leading to remission of psoas muscle abscess. As for psoas muscle abscess secondary to catheter-related infection, all previous cases were related to catheter used for vascular access and catheters inserted into the jugular, subclavian, or femoral veins for temporal or permanent use [7,8,19,20,22,25,27]. In this regard, our case is the first to report psoas muscle abscess caused by epidural catheter used for continuous epidural anesthesia.…”

“…Hence, further studies are necessary to determine whether the risk for epidural catheter-related infection in hemodialysis patients with active herpes zoster is higher than those without active herpes zoster. Psoas muscle abscess is a rare but lethal complication that is occasionally seen in hemodialysis patients [8][9][10][18][19][20][21][22][23][24][25][26][27][28]. Triad of the classical psoas muscle abscess consists of fever, pain, and limp [29].…”

“…A previous report showed that the prognosis of secondary psoas abscess is worse than primary psoas abscess, and unless open surgical drainage is performed, its prognosis is unacceptable [30]. Table 3 summarized the previous 22 reports including our case on psoas muscle abscess in hemodialysis patients [8][9][10][19][20][21][22][23][24][25][26][27][28]. The age of the patients ranged from 45 to 78 years.…”

Early and long-term complications in haemodialysis vascular access

“…In addition to local infections, distant infections occur, in the form of abscesses of the lungs and the spine, as well as infectious endocarditis and systemic infection -sepsis [2,[10][11][12][13][14][15].…”

“…Arteriovenous fistulas and dialysis catheters are the basic elements in carrying out haemodialysis and keeping patients with end-stage renal disease alive in order to prepare them for the planned kidney transplant. The preferred vascular access, which remains the gold standard, is an autogenous arteriovenous fistula [1,2].…”