Turunç Tahsin, Turunç Tuba, Demiroğlu Y Ziya, Colakoğlu Sule
Başkent Universitesi Tip Fakültesi, Uroloji Anabilim Dali, Ankara.
Mikrobiyol Bul. 2009 Jan;43(1):121-5.
Psoas abscesses are suppurative collections within the fascia surrounding the psoas and iliacus muscles. In this retrospective study it was aimed to evaluate the demographic characteristics, clinical and laboratory findings and treatment outcomes of 15 psoas abscess cases admitted to Baskent University Hospital, Ankara, Turkey during June 2003-January 2008 period. The mean age of the patients was 55.8 years (range 18 to 70 years) with a female to male ratio of 5/10. Thirteen of the cases (86.5%) were admitted with the complaints of fever and back pain. Thirteen of the cases were diagnosed by abdominal computerized tomography while the other two by abdominal ultrasonography. One of the 15 patients was considered as primary psoas abscess, while the remaining 14 as secondary psoas abscess. The most common accompanying disease was diabetes mellitus (66.6%). Fourteen patients with secondary psoas abscess had vertebral osteomyelitis which was due to tuberculosis in five cases, to urinary tract infection in five cases, to pneumoniae in two cases, to surgical infection in one case and to brucellosis in one case. The cultivation of the abscess material from the 14 secondary psoas abscess cases revealed growth of bacteria in 11 of them (5 Mycobacterium tuberculosis, 1 Escherichia coli, 1 methicillin-sensitive Staphylococcus aureus, 1 methicilin-resistant S. aureus, 1 Acinetobacter baumannii, 1 Brucella melitensis, 1 Serratia marcescens). The biochemical parameters of the cases (mean leukocyte counts: 14.500 cell/mm3; mean erythrocyte sedimentation rates: 78 mm/hour; mean C-reactive protein levels: 108 mg/dl) were also high. Thirteen patients underwent percutaneous drainage and received appropriate antibiotic treatment and the other two patients were treated with open surgical debridement. The duration of antimicrobial treatment was one year for M. tuberculosis cases and about 4-6 weeks in the others. One of the cases died due to complicating meningitis and sepsis. It is remarkable that in our series none of the psoas abscess cases were secondary to the diseases of the digestive tract unlike the series indicated in the literature. The isolation of M. tuberculosis as the causative agent in 5 (33.3%) cases emphasizes the fact that tuberculosis is still an important public health problem in Turkey.
腰大肌脓肿是指腰大肌和髂肌周围筋膜内的化脓性积液。在这项回顾性研究中，旨在评估2003年6月至2008年1月期间入住土耳其安卡拉巴斯肯特大学医院的15例腰大肌脓肿患者的人口统计学特征、临床和实验室检查结果以及治疗效果。患者的平均年龄为55.8岁（范围为18至70岁），男女比例为5/10。其中13例（86.5%）因发热和背痛入院。13例通过腹部计算机断层扫描诊断，另外2例通过腹部超声诊断。15例患者中1例被认为是原发性腰大肌脓肿，其余14例为继发性腰大肌脓肿。最常见的伴随疾病是糖尿病（66.6%）。14例继发性腰大肌脓肿患者患有脊椎骨髓炎，其中5例因结核病，5例因尿路感染，2例因肺炎，1例因手术感染，1例因布鲁氏菌病。对14例继发性腰大肌脓肿病例的脓肿材料进行培养，结果显示其中11例有细菌生长（5例结核分枝杆菌、1例大肠杆菌、1例甲氧西林敏感金黄色葡萄球菌、1例耐甲氧西林金黄色葡萄球菌、1例鲍曼不动杆菌、1例马尔他布鲁氏菌、1例粘质沙雷氏菌）。这些病例的生化参数（平均白细胞计数：14,500个/mm³；平均红细胞沉降率：78mm/小时；平均C反应蛋白水平：108mg/dl）也很高。13例患者接受了经皮引流并接受了适当的抗生素治疗，另外2例患者接受了开放性手术清创。结核分枝杆菌病例的抗菌治疗持续时间为1年，其他病例约为4至6周。1例患者因并发脑膜炎和败血症死亡。值得注意的是，与文献报道的系列不同，在我们的系列中，没有一例腰大肌脓肿病例继发于消化道疾病。5例（33.3%）病例中分离出结核分枝杆菌作为病原体，这突出了结核病在土耳其仍然是一个重要的公共卫生问题这一事实。
