Ruiz de la Hermosa A, Amunategui-Prats I, Hurtado-Caballero E, Cortese S, Muñoz-Calero Peregrin A
Cirugía General y del Aparato Digestivo, Cirugía General I. Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Rev Gastroenterol Mex. 2011 Oct-Dec;76(4):366-9.
Psoas abscess is a pus collection within the muscle compartment. It is a very uncommon entity. It can be primary as a result of haematogenous spread or secondary as a consequence of a direct extension of an infectious focus. Diagnosis is usually delayed because nonspecific clinical presentation. Staphylococcus aureus is the most common organism cultured in this type of abscess. We describe a secondary psoas abscess in an elderly female patient. The patient presented with fever, right groin pain and malaise. Following laboratory, radiological and microbiological analyses the patient was diagnosed as having a psoas abscess due to Pasteurella multocida, which is a Gram negative bacteria, part of the normal oral flora of many animals and can causes human infections after animal scratches or bites. More rarely is to find this organism causing psoas abscesses. Because of insidious clinical presentation, the diagnosis of psoas abscess is a challenge and a high index of suspicion is required. We emphasize the importance of bacteriological confirmation of microorganism involved to choose the correct antibiotics. Percutaneous drainage is the treatment of choice. Open surgical drainage should be reserved if percutaneous drainage fails.
腰大肌脓肿是指肌肉间隙内的积脓。这是一种非常罕见的病症。它可以是血行播散导致的原发性脓肿，也可以是感染灶直接蔓延引起的继发性脓肿。由于临床表现不具特异性，诊断通常会延迟。金黄色葡萄球菌是这类脓肿培养中最常见的微生物。我们描述了一位老年女性患者的继发性腰大肌脓肿。该患者表现为发热、右腹股沟疼痛和全身不适。经过实验室、影像学和微生物学分析，患者被诊断为因多杀巴斯德菌引起的腰大肌脓肿，多杀巴斯德菌是一种革兰氏阴性菌，是许多动物正常口腔菌群的一部分，在动物抓伤或咬伤后可导致人类感染。更罕见的是发现这种微生物引起腰大肌脓肿。由于临床表现隐匿，腰大肌脓肿的诊断具有挑战性，需要高度怀疑。我们强调对所涉及的微生物进行细菌学确认以选择正确抗生素的重要性。经皮引流是首选的治疗方法。如果经皮引流失败，则应采用开放手术引流。
