Psoas abscess in a drug addict

Abstract

Letters to the Editor Sleep apnoea syndromea too frequent misdiagnosis Sir, A 45 year old woman, experienced progressive deterioration of memory, loss of concentration, anxiety, tiredness, insomnia with nightmares and arousals characterized by unexplained fear and, rarely, thoughts of suicide. She developed a profound depression, so that 2 months later in November 1987 she decided to discontinue herjob in the stock market. A diagnosis of menopausal-related anxious depressive syndrome was made by her general practitioner and confirmed by two psychiatrists. However neither ethynyl oestradiol, imipramine or diazepam relieved her symptoms. From January to April 1988 two further therapeutic trials with trazodone and tranylcypromine were unsuccessful. In January 1988, she consulted an internist who noticed that her voice had a peculiar timbre, consistent with upper airway obstruction. Examination revealed narrowing of the oropharyngeal airway by excessive folds of the soft palate: fibreoptic examination excluded any coexistent hypopharyngeal or laryngeal obstruction. Polysomnography demonstrated a typical pattern of obstructive apnoea,' with 49 obstructive episodes per hour characterized by arterial oxygen desaturation up to 35%. The most severe of these episodes were terminated by sudden arousal and the presenting symptoms. Application of continuous positive airway

Acute Radiologic Manifestations of America’s Opioid Epidemic

“…Ultrasonographic (US) images may show a fluid collection with debris or internal echoes that are indicative of the complexity of the fluid. The abscesses may occur locally at the site of injection, or they may be seen in deeper locations such as the psoas muscle (63), having spread via the bloodstream. Osteomyelitis due to local extension of a soft-tissue infection or hematogenous spread also may occur (Figs 10-12).…”