Liao Y S, Shih H N, Hsu R W
Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1995 Jun;18(2):170-5.
The clinical presentation of psoas abscess is often non-specific and insidious that may mislead the diagnosis and treatment. The abscess often extends beyond the retroperitoneum and pelvis before its diagnosis, and leads to serious complications. Many diseases have the similar signs and symptoms and must be ruled out. Computed tomogram is the most useful and reliable diagnostic tool. Only a few cases of salmonella psoas abscess were reported in the literature, and were usually associated with spinal osteomyelitis or septic hip. We present a case of salmonella psoas abscess in a patient with diabetes mellitus. The patient had the history of cholecystitis with sepsis due to salmonella infection 4 years before and cholecystectomy had been done. No associated lesion was found to be associated with the abscess, and we believed the abscess being the result of recurrent bacteremic attack. High index of suspicion, early diagnosis, adequate drainage and effective antibiotic treatment are the key points in managing the disease.
腰大肌脓肿的临床表现通常不具有特异性且隐匿，可能会误导诊断和治疗。在诊断之前，脓肿常常会延伸至腹膜后和盆腔以外，并导致严重的并发症。许多疾病具有相似的体征和症状，必须予以排除。计算机断层扫描是最有用且可靠的诊断工具。文献中仅报道了少数几例沙门氏菌腰大肌脓肿病例，且通常与脊柱骨髓炎或化脓性髋关节炎相关。我们报告一例糖尿病患者的沙门氏菌腰大肌脓肿病例。该患者4年前有因沙门氏菌感染导致胆囊炎伴败血症的病史，已行胆囊切除术。未发现与脓肿相关的其他病变，我们认为该脓肿是反复菌血症发作的结果。高度的怀疑指数、早期诊断、充分引流以及有效的抗生素治疗是管理该疾病的关键要点。
