Literature review and a case report of spontaneous subscapular abscess in a child

Abstract

Subscapular space is an uncommon site for abscess formation. There are only seven reports of subscapular abscesses in the literature. Only three of these cases are reported in children. We recently treated a child with subscapular abscess. We performed the literature search using a combination of the keywords: subscapular, scapular, abscess and infection. One case was diagnosed on post-mortem autopsy, and only three of these cases are reported in children. The organism was Staphylococcus aureus in five cases (two were methicillin-resistant S. aureus), Haemophilus influenzae in one case, and no organism was grown in the last case. (Patient received a course of empirical antibiotics and samples did not grow any organism.) We describe a case of spontaneous subscapular abscess in a 7-year-old boy. The abscess was visualised on magnetic resonance imaging (MRI), and the organism was identified as S. aureus bacteria. The abscess was treated surgically with debridement and antibiotics, and the patient had full recovery with no subsequent effects. Subscapular abscess needs high index of suspicion and early imaging investigation. MRI is the modality of choice for accurate diagnosis. Early intervention leads to favourable outcome, while delays in diagnosis can be fatal.

Dorsal subscapularis approach for the surgical drainage of subscapularis intramuscular abscess: a case report

“…Immunocompromised states, such as diabetes [4] or hematoma due to shoulder trauma [3, 5], which are thought to be the sources of infection, have been reported as predisposing conditions. However, as in the present case, cases without any underlying disease have also been reported [1, 2].…”

“…However, as in the present case, cases without any underlying disease have also been reported [1, 2].…”

“…The subscapularis muscle is an infrequent location of abscess formation, and the diagnosis of an abscess within the subscapularis muscle is often difficult [1, 2]. Because of its rarity, few reports are available on the treatment methods for abscesses located in the subscapularis muscle.…”

Nedeni Bilinmeyen Ateş Nedeni: Supskapular Apse

“…Otit sonrası gelişen subskapular apsede Haemophilus influenzae Tip B izole edilmiştir [2] . Literatürde en sık metisiline duyarlı S. aureus (MSSA) etken olarak bildirilmiştir [1,[3][4][5][6] . Bazı olgularda ise MRSA izole edilmiştir [4,7,8] .…”

“…Omuz hareket kısıtlılığı olması nedeniyle septik omuz artrit ile ayırıcı tanısı yapılmalıdır; glenohumeral eklemde infeksiyon bulgularının olmaması subskapular apse lehine düşünülebilir. Ayrıca benign ve malign kitlelerin ekartasyonu da yapılmalıdır [6] . Operasyon öncesi yapılacak MRG tanı, ayırıcı tanı ve apse drenaj planının yapılabilmesi açısından oldukça önemlidir.…”