Jang T N, Juang G D, Fung C P
Department of Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan ROC.
J Formos Med Assoc. 1997 Feb;96(2):134-6.
Psoas muscle abscess due to Klebsiella pneumoniae infection is rare. We report a 55-year-old diabetic man who presented with progressive back pain of 1 month's duration. The patient had undergone surgical drainage for a deep neck infection with K. pneumoniae 43 days previously. On the present admission, physical examination revealed tenderness over the anterior upper aspect of both thighs, and computed tomography showed pneumoretroperitoneum dissecting the bilateral iliopsoas muscles. Parenteral administration of antibiotics was started immediately. Due to the patient's poor health status, we opted for repeated computed tomographic and sonographic-guided percutaneous drainage rather than surgical drainage. Blood and pus cultures revealed only K. pneumoniae. The patient recovered without significant sequelae. This report stresses the risk of metastatic infections caused by K. pneumoniae, especially in diabetic patients. Our experience suggests that repeated percutaneous drainage is feasible in cases of severe iliopsoas abscess, especially when risks associated with surgery are high.
肺炎克雷伯菌感染所致的腰大肌脓肿较为罕见。我们报告一例55岁的糖尿病男性患者，其出现了持续1个月的进行性背痛。该患者在43天前因肺炎克雷伯菌引起的深部颈部感染接受了外科引流。此次入院时，体格检查发现双侧大腿前上部有压痛，计算机断层扫描显示腹膜后积气将双侧髂腰肌分开。立即开始静脉注射抗生素。由于患者健康状况较差，我们选择重复进行计算机断层扫描和超声引导下经皮引流，而非外科引流。血液和脓液培养仅发现肺炎克雷伯菌。患者康复，未留下明显后遗症。本报告强调了肺炎克雷伯菌引起转移性感染的风险，尤其是在糖尿病患者中。我们的经验表明，对于严重的髂腰肌脓肿，尤其是手术风险较高的情况下，重复经皮引流是可行的。
