Mougui Ahmed, El Bouchti Imane
Department of Rheumatology, Mohammed VI University Hospital, Marrakech, Morocco.
SAGE Open Med Case Rep. 2024 Jun 6;12:2050313X241260184. doi: 10.1177/2050313X241260184. eCollection 2024.
Primary psoas abscess is an uncommon yet critical factor contributing to postpartum sepsis. This report is of a case of postpartum primary psoas abscess in a 24-year-old Moroccan woman. After an uncomplicated vaginal delivery, a 24-year-old primiparous Moroccan woman presented to our hospital with a 3-week history of severe left-sided lower abdominal pain that radiated to the anterior aspect of the left thigh. She had been taking ciprofloxacin, metronidazole, and paracetamol for a week without any improvement. On examination, she was febrile and pale. The laboratory analysis revealed the presence of microcytic anemia, an elevated erythrocyte sedimentation rate, and an increased level of C-reactive protein. Computed tomography scans of the abdomen, and pelvis were conducted, revealing a substantial left psoas abscess. Under the guidance of computed tomography, anterior abdominal percutaneous drainage of the abscess was successfully performed. A pan-sensitive strain was identified through culture of the specimen. The patient showed a favorable response to treatment with amoxicillin/clavulanate and gentamicin. This case illustrates that primary psoas abscess should be considered in cases of any postpartum infectious presentation.
原发性腰大肌脓肿是导致产后败血症的一个罕见但关键的因素。本文报告一例24岁摩洛哥女性产后原发性腰大肌脓肿的病例。一名24岁初产摩洛哥女性在顺产无并发症后,因左侧下腹部剧痛3周前来我院就诊,疼痛放射至左大腿前侧。她服用环丙沙星、甲硝唑和扑热息痛一周,症状无任何改善。检查时,她发热且面色苍白。实验室分析显示存在小细胞贫血、红细胞沉降率升高和C反应蛋白水平升高。对腹部和骨盆进行了计算机断层扫描,发现左侧腰大肌有一个巨大脓肿。在计算机断层扫描引导下,成功地对脓肿进行了经皮前腹壁引流。通过标本培养鉴定出一种对多种药物敏感的菌株。患者对阿莫西林/克拉维酸和庆大霉素治疗反应良好。该病例表明,任何产后感染表现的病例都应考虑原发性腰大肌脓肿。