scholarly journals Bilateral Primary Iliopsoas Abscess with Bilateral Hip Septic Arthritis – A Rare Case Report

2021 ◽  
Vol 11 (10) ◽  
Author(s):  
James C George ◽  
Jishar Sainulabdeen ◽  
Samuel Chittaranjan ◽  
Subin Babu
Keyword(s):  
Septic Arthritis ◽  
Psoas Abscess ◽  
Iliac Vein ◽  
Underlying Disease ◽  
Lower Limbs ◽  
Iliopsoas Abscess ◽  
Rare Case Report ◽  
Disc Bulge ◽  
Sources Of Infection ◽  
Uncommon Condition

Introduction:Iliopsoas abscess is an uncommon condition, often with insidious and nonspecific symptoms. Patients often present with a limp, fever, weight loss, and flank or abdominal pain. An iliopsoas abscess can be either primary or secondary depending on the presence or absence of an underlying disease. Primary abscess is very common in Asia and other developing countries. If untreated, iliopsoas abscess can spread to lower limbs, compress iliac vein, ureter and can end up in sepsis. There have been only a very small number of cases of psoas abscess with associated hip septic arthritis reported so far. Bilateral iliopsoas abscess is also a rare entity. Case Report:We report here a 58-year-old diabetic lady with fever and both hip pain subsequent to a fall at home one month back around one 1 month before. . She was initially seen elsewhere, and a diagnosis of L4-L5 disc bulge was made following which rest , analgesics and steroids were given. Later, repeat magnetic resonance imageMRI showed bilateral Iliacus abscess and bilateral hip synovitis. She was started on anti anti-tuberculosis medications and referred to us. We investigated for occult sources of infection and did bilateral iliopsoas abscess drainage followed by staged bilateral total hip replacement. She now continues to be symptom free. Conclusion: Our patient had primary bilateral iliopsoas abscess with bilateral hip Streptococcus faeeacalis septic arthritis. It has not been reported in the literature till now. Clinical Message:Early diagnosis through meticulous clinical examination and investigations is important in treatment of the abscess and reducing morbidity and mortality. Keywords:Primary iliopsoas abscess, septic arthritis, bilateral iliopsoas abscess.

Every loin swelling in an infant is not a renal mass: rare presentation of psoas abscess in an infant

2020 ◽  
Vol 13 (11) ◽  
pp. e237137
Author(s):  
Dilip Kumar Venkatesan ◽  
Himanshi Chaudhary ◽  
Sanjay Verma
Keyword(s):  
Early Detection ◽  
Renal Mass ◽  
Psoas Abscess ◽  
Staphylococcal Infection ◽  
Rare Presentation ◽  
Iliopsoas Abscess ◽  
Affected Side ◽  
Uncommon Condition ◽  
Thigh Swelling

Primary iliopsoas abscess (IPA) in infants is an uncommon condition. It presents as inguinal or thigh swelling with limitation of movements on the affected side. Early detection and timely drainage of the abscess can prevent serious complications related to the dissemination of infection. We report a case of primary IPA due to methicillin-sensitive staphylococcal infection presenting as a left lumbar mass in an immune-competent infant. The abscess was detected in time, drained surgically and treated with cloxacillin for 4 weeks, thereby preventing serious complications.

scholarly journals A rare case report of psoas abscess in pregnancy in a tertiary centre

2021 ◽  
Vol 11 (1) ◽  
pp. 272
Author(s):  
Niranjan N. Chavan ◽  
Umme Ammara ◽  
Zaneta Dias ◽  
Manan Boob
Keyword(s):  
Case Report ◽  
Psoas Abscess ◽  
Spinal Tuberculosis ◽  
Signs And Symptoms ◽  
Clinical History ◽  
Interesting Case ◽  
Tertiary Centre ◽  
Rare Case Report ◽  
Uncommon Condition ◽  
In Pregnancy

A psoas abscess in pregnancy is a relatively uncommon condition with nonspecific signs and symptoms. It may lead to serious complications if not diagnosed and treated promptly. Although spinal tuberculosis affects nearly half of skeletal tuberculosis patients, psoas abscess develops in only 5% of spinal tuberculosis cases. A clinical history and examination are used to make a diagnosis, which is then confirmed by microbiology and radiological findings. Here is an interesting case report on psoas abscess in pregnancy managed by pigtail catheter insertion and drainage.

scholarly journals An enemy in shadows; Mycoplasma hominis septic arthritis and iliopsoas abscess: case report and review of the literature.

IDCases ◽  
2021 ◽  
pp. e01260
Author(s):  
Gawahir A. Ali ◽  
Wael Goravey ◽  
Abdulrahman Hamad ◽  
Emad B. Ibrahim ◽  
Mohamed R. Hasan ◽  
...  
Keyword(s):  
Case Report ◽  
Septic Arthritis ◽  
Mycoplasma Hominis ◽  
Review Of The Literature ◽  
Iliopsoas Abscess

Evidence for the Non-Infectious Etiology of Early Postoperative Fever

1985 ◽  
Vol 6 (7) ◽  
pp. 273-277 ◽  
Author(s):  
Richard A. Garibaldi ◽  
Susan Brodine ◽  
Sego Matsumiya ◽  
Miki Coleman
Keyword(s):  
General Surgery ◽  
Underlying Disease ◽  
Therapeutic Interventions ◽  
Empiric Antibiotic Therapy ◽  
Postoperative Fever ◽  
Wide Range ◽  
Severe Underlying Disease ◽  
Empiric Antibiotic ◽  
Sources Of Infection ◽  
A Prospective Study

AbstractIn a prospective study of infections in 871 general surgery patients, we identified 81 patients who developed unexplained postoperative fevers. The majority of these episodes (72%) occurred early (within the first 48 hours) following surgery. Patients who developed early, unexplained fevers differed significantly from patients who developed documented postoperative infections. Patients with unexplained fevers were younger, had less severe underlying disease and underwent less extensive surgeries than patients who subsequently developed infections. In these respects, they were more similar to non-infected, non-febrile patients.We concluded that episodes of early, unexplained postoperative fever occur frequently in a wide range of general surgery patients. Most of these episodes are non-infectious in origin. Patients with early postoperative fevers should be evaluated to identify any obvious sources of infection. If no focus is identified, empiric antibiotic therapy should not be initiated nor should prophylactic antibiotics be extended for prolonged durations. Unexplained fevers will resolve in time without specific therapeutic interventions.

Rothia mucilaginosa: a case of septic arthritis in a native knee and review of the literature

2021 ◽  
Vol 14 (1) ◽  
pp. e237015
Author(s):  
Ahmed Daoub ◽  
Hamza Ansari ◽  
George Orfanos ◽  
Andrew Barnett
Keyword(s):  
Respiratory Tract ◽  
Septic Arthritis ◽  
Rare Case ◽  
Patient Management ◽  
Review Of The Literature ◽  
Gram Positive ◽  
Rothia Mucilaginosa ◽  
Uncommon Condition ◽  
Learning Points

Rothia mucilaginosa is a Gram-positive aerobic coccus usually found in the oral and respiratory tract. Septic arthritis is an uncommon condition, but is an orthopaedic emergency. A rare case of knee septic arthritis due to R. mucilaginosa is presented. Patient management and outcomes are discussed, and learning points from this case are outlined to help manage any further cases that may arise.

Hemodialysis Reliable Outflow graft: A valid option in patients with central venous stenosis

2020 ◽  
Vol 21 (6) ◽  
pp. 1023-1028
Author(s):  
Ana Carolina Figueiredo ◽  
Filipe Mira ◽  
Luís Rodrigues ◽  
Emanuel Ferreira ◽  
Nuno Oliveira ◽  
...  
Keyword(s):  
Vascular Access ◽  
Venous Catheter ◽  
Iliac Vein ◽  
Lower Limbs ◽  
Implantation Technique ◽  
Central Venous ◽  
Vein Thrombosis ◽  
Central Venous Stenosis ◽  
Venous Stenosis ◽  
Outflow Graft

Introduction: Central venous stenosis can be the main obstacle to the creation of an autologous vascular access in the upper limbs. The Hemodialysis Reliable Outflow graft was developed to provide an upper limb vascular access option to such patients, avoiding alternative, less advantageous options, such as lower limb vascular accesses or central venous catheters. Its advantages include catheter avoidance and, in case of lower limbs accesses, reduction of the ischemic risk and iliac vein thrombosis, potentially compromising a future kidney transplant. Patients and methods: Revision of the clinical files of the four patients who were placed a Hemodialysis Reliable Outflow device in our Center, including demographic variables, implantation technique characteristics, surgical complications, episodes of infection and thrombosis of the access, and need to place a transitory central venous catheter to undergo hemodialysis treatment. Results: Four Hemodialysis Reliable Outflow grafts were placed, which resulted in a significant improvement in the dialysis efficacy in all patients, with a median raise in the Kt/V of 36.7%. Two cases needed thrombectomy, one of which was unsuccessful. The actual time of patency varies between 3 and 28 months. Conclusion: Our experience with the Hemodialysis Reliable Outflow device showed that it was a safe option for patients with central venous stenosis and was associated with good clinical and analytic outcomes.

Iliac Venous Obstruction: Surgical Reconstruction

2000 ◽  
Vol 15 (3-4) ◽  
pp. 144-148
Author(s):  
F. Mercier ◽  
F. Cormier ◽  
J. M. Fichelle ◽  
F. Duarte ◽  
J. M. Cormier
Keyword(s):  
Iliac Artery ◽  
Lower Limb ◽  
Iliac Vein ◽  
Lower Limbs ◽  
Surgical Reconstruction ◽  
Invasive Technique ◽  
Venous Obstruction ◽  
Long Term Outcome ◽  
First Choice

Aim: To review the investigation and treatment of iliac vein obstruction. Method: A review of current literature in the field of management of iliac venous obstruction has been conducted. Synthesis: Iliac venous obstruction results in chronic or acute symptoms in the lower limb presenting as pain, swelling, oedema and discomfort of the lower limb. Intrinsic or extrinsic obstruction of the iliac veins may be the cause. Cockett syndrome is the classic aetiology for chronic intermittent or fixed left inferior limb venous obstruction. Other causes include tumours, vascular grafts or lymph node compression and retroperitoneal fibrosis. Duplex ultrasound imaging is now the first-choice investigation. CT scanning is useful where external vein compression is suspected. Phlebography is used when an endovascular procedure is to be done. The surgical treatment of Cockett syndrome described by Cormier is transposition of the common right iliac artery in the left internal iliac artery. This is being replaced by endovascular balloon venoplasty completed by stenting of the left iliac vein. We reviewed the experience of surgical correction of Cockett syndrome with Cormier's technique in 70 patients operated on between 1976 and 1990; 55 patients had a follow-up of 12-177 months. Anatomical and functional results were perfect for all patients except when endoluminal synechiae or iliac venous thrombosis were associated with postural compression. In this case a 50% success rate was achieved. The endovascular revolution offers a less invasive technique for treatment of chronic iliac venous obstruction. Follow-up is short at present in the few publications found in the literature. Conclusions: Iliac vein obstruction results in symptoms of swelling in the lower limbs. These may be managed conservatively. Where there is an indication for venous reconstruction, investigation by duplex ultrasonography is the first step. Endovascular procedures including stenting offer significant benefit. The long-term outcome of these interventions has yet to be established.

Septic arthritis in adults

2013 ◽  
Author(s):  
Laura McGregor ◽  
Monica N. Gupta ◽  
Max Field
Keyword(s):  
Septic Arthritis ◽  
Inflammatory Responses ◽  
Joint Disease ◽  
Medical Emergency ◽  
British Society ◽  
Future Research ◽  
Mortality And Morbidity ◽  
Medical Disorders ◽  
Sources Of Infection ◽  
Joint Prostheses

Septic arthritis (SA) is a medical emergency with mortality of around 15%. Presentation is usually monoarticular but in more than 10% SA affects two or more joints. Symptoms include rapid-onset joint inflammation with systemic inflammatory responses but fever and leucocytosis may be absent at presentation. Treatment according to British Society of Rheumatology/British Orthopaedic Association (BSR/BOA) guidelines should be commenced if there is a suspicion of SA. At-risk patients include those with primary joint disease, previous SA, recent intra-articular surgery, exogenous sources of infection (leg ulceration, respiratory and urinary tract), and immunosupression because of medical disorders, intravenous drug use or therapy including tumour necrosis factor (TNF) inhibitors. Synovial fluid should be examined for organisms and crystals with repeat aspiration as required. Most SA results from haematogenous spread-sources of infection should be sought and blood and appropriate cultures taken prior to antibiotic treatment. Causative organisms include staphylococcus (including meticillin-resistant Staphylococcus aureus, MRSA), streptococcus, and Gram-negative organisms (in elderly patients), but no organism is identified in 43%, often after antibiotic use before diagnosis. Antibiotics should be prescribed according to local protocols, but BSR/BOA guidelines suggest initial intravenous and subsequent oral therapy. Medical treatment may be as effective as surgical in uncomplicated native SA, and can be cost-effective, but orthopaedic advice should be sought if necessary and always in cases of infected joint prostheses. In addition to high mortality, around 40% of survivors following SA develop limitation of joint function. Guidelines provide physicians with treatment advice aiming to limit mortality and morbidity and assist future research.

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