Hsu Ron-Bin, Lin Fang-Yue
Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China.
J Vasc Surg. 2007 Aug;46(2):230-5. doi: 10.1016/j.jvs.2007.04.017. Epub 2007 Jun 27.
Psoas abscess is an uncommon disease, and its presenting features are usually nonspecific. Infected aortic aneurysms could be complicated by psoas abscess.
A retrospective chart review was conducted to examine the incidence, clinical presentations, microbiology, and outcomes of psoas abscess in patients with an infected aortic aneurysm.
Between 1996 and 2007, 40 patients (32 men) with an infected infrarenal aortic aneurysm were treated in our hospital. Their median age was 71 years (range, 38 to 88 years). In 38 patients a blood or tissue culture had a positive result. The most common responsible pathogen was Salmonella spp in 29 patients (76%), followed by Staphylococcus aureus in 3 (8%), Escherichia coli in 2 (5%), Klebsiella pneumoniae in 3 (8%), and Mycobacterium tuberculosis in 1 (3%). One patient underwent endovascular repair but died. In-situ graft replacement was done in 32 patients. Persistent or recurrent infection occurred in seven (22%) of 32 operated on patients. The mortality rate was 86%, and the overall aneurysm-related mortality rate of in situ graft replacement was 22% (7/32). In eight (20%) of the 40 patients, aortic infection was complicated by psoas abscess. Infection complicated by psoas abscess was present in seven of 32 operated patients. It was associated with higher incidence of emergency operation, hospital mortality, prosthetic graft infection, and aneurysm-related mortality than infection without abscess.
Psoas abscess was common in patients with infected infrarenal aortic aneurysm. Salmonella spp was the most common pathogen. Psoas abscess was associated with a high mortality rate, emergency operation, and persistent infection.
腰大肌脓肿是一种罕见疾病，其临床表现通常不具有特异性。感染性主动脉瘤可并发腰大肌脓肿。
进行一项回顾性病历审查，以研究感染性主动脉瘤患者腰大肌脓肿的发病率、临床表现、微生物学及治疗结果。
1996年至2007年期间，我院共治疗40例（32例男性）感染性肾下腹主动脉瘤患者。他们的中位年龄为71岁（范围38至88岁）。38例患者的血液或组织培养结果呈阳性。最常见的致病病原体是沙门氏菌属，共29例（76%），其次是金黄色葡萄球菌3例（8%）、大肠杆菌2例（5%）、肺炎克雷伯菌3例（8%）、结核分枝杆菌1例（3%）。1例患者接受了血管腔内修复术，但死亡。32例患者进行了原位移植物置换。32例接受手术的患者中有7例（22%）发生持续性或复发性感染。死亡率为86%，原位移植物置换的总体动脉瘤相关死亡率为22%（7/32）。40例患者中有8例（20%）发生了并发腰大肌脓肿的主动脉感染。32例接受手术的患者中有7例发生了并发腰大肌脓肿的感染。与无脓肿的感染相比，其急诊手术、医院死亡率、人工血管感染及动脉瘤相关死亡率的发生率更高。
腰大肌脓肿在感染性肾下腹主动脉瘤患者中较为常见。沙门氏菌属是最常见的病原体。腰大肌脓肿与高死亡率、急诊手术及持续性感染相关。
