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1996-02-27
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Document 0605
DOCN M9630605
TI Primary vs secondary iliopsoas abscess. Presentation, microbiology, and
treatment.
DT 9603
AU Santaella RO; Fishman EK; Lipsett PA; Department of Surgery, Johns
Hopkins University School of; Medicine, Baltimore, Md, USA.
SO Arch Surg. 1995 Dec;130(12):1309-13. Unique Identifier : AIDSLINE
MED/96094963
AB OBJECTIVE: To review the characteristics of patient presentation,
microbiology, and treatment of primary iliopsoas abscess. DESIGN: A case
series of patients with iliopsoas abscess diagnosed on computed
tomographic scans from 1987 to 1994. SETTING: Tertiary care inner-city
university hospital. PATIENTS: Eleven patients with secondary iliopsoas
abscess, defined as being secondary to gastrointestinal or genitourinary
causes or trauma, and seven patients with primary abscess, defined as
the absence of the above causes. MAIN OUTCOME MEASURES: Patient
characteristics, presenting symptoms and signs, microbiologic
characteristics, treatment, and clinical course of patients with primary
iliopsoas abscesses compared with those in patients with secondary
abscesses. RESULTS: In the primary group, six patients (86%) were
intravenous drug users and four (57%) were positive for human
immunodeficiency virus. Staphylococcus aureus grew from cultures from
five of seven patients with primary abscesses, whereas secondary
abscesses had enteric flora. The typical patient presentation included
fever, with complaints of pain in the flank, hip, or abdomen. Comparison
of abscess drainage options showed shorter hospitalizations for surgical
drainage than for percutaneous drainage (15.9 vs 28.5 days; P < or =
.01). CONCLUSIONS: A patient who presents with pain in the flank, hip,
or abdomen may have a primary iliopsoas abscess. Computed tomography is
the standard method of diagnosis. Antibiotic regimens for patients with
primary iliopsoas abscess should include coverage for S aureus, and
patients with secondary abscesses should have antibiotic regimens
tailored for enteric bacteria. Drainage of abscess is essential for
appropriate treatment, and surgical drainage is superior to percutaneous
drainage in achieving prompt recovery.
DE Adolescence Adult Aged Aged, 80 and over AIDS-Related Opportunistic
Infections Child Child, Preschool Drainage Female Human Male
Middle Age *Psoas Abscess/DIAGNOSIS/MICROBIOLOGY/THERAPY Retrospective
Studies Tomography, X-Ray Computed Treatment Outcome JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).