Silva Ana M, Schmalbach Lauwence A
Servicio de Pediatría. Hospital Central de Pediatría Dr. Claudio Zin, Malvinas Argentinas, Buenos Aires.
Servicio de Ortopedia y Traumatología. Hospital Municipal de Trauma y Emergencias Dr. Federico Abete, Malvinas Argentinas, Buenos Aires.
Arch Argent Pediatr. 2016 Oct 1;114(5):e333-7. doi: 10.5546/aap.2016.e333.
Psoas abscess is a common disease in children. It can have a nonspecific clinical presentation, insidious onset and sometimes fever. The most common type in children is the primary one; however, it can sometimes be of secondary origin and associated with severe infections such as osteomyelitis so a high index of suspicion is required to detect and treat it promptly. We present an unusual case of psoas abscess with infiltration of the vertebral body of L2 in a 14 year old male patient previously healthy with no history of trauma or fever on admission. X-ray and ultrasound were performed but the diagnosis was confirmed by magnetic resonance imaging of the lumbosacral spine. With positive blood cultures for methicillin-resistant Staphylococcus aureus he completed 2 weeks of intravenous antibiotic therapy and 4 weeks of oral antibiotic therapy with blood cultures negativization and resolution of symptoms.
腰大肌脓肿是儿童的常见疾病。其临床表现可能不具特异性,起病隐匿,有时伴有发热。儿童中最常见的类型是原发性的;然而,它有时也可能是继发性的,与骨髓炎等严重感染有关,因此需要高度怀疑才能及时发现并治疗。我们报告一例不寻常的腰大肌脓肿病例,该病例发生在一名14岁男性患者身上,其L2椎体有浸润,患者此前身体健康,入院时无创伤或发热史。进行了X线和超声检查,但腰段脊柱的磁共振成像确诊了该病。由于耐甲氧西林金黄色葡萄球菌血培养呈阳性,他完成了2周的静脉抗生素治疗和4周的口服抗生素治疗,血培养转阴且症状缓解。