       Document 0605
 DOCN  M9630605
 TI    Primary vs secondary iliopsoas abscess. Presentation, microbiology, and
       treatment.
 DT    9603
 AU    Santaella RO; Fishman EK; Lipsett PA; Department of Surgery, Johns
       Hopkins University School of; Medicine, Baltimore, Md, USA.
 SO    Arch Surg. 1995 Dec;130(12):1309-13. Unique Identifier : AIDSLINE
       MED/96094963
 AB    OBJECTIVE: To review the characteristics of patient presentation,
       microbiology, and treatment of primary iliopsoas abscess. DESIGN: A case
       series of patients with iliopsoas abscess diagnosed on computed
       tomographic scans from 1987 to 1994. SETTING: Tertiary care inner-city
       university hospital. PATIENTS: Eleven patients with secondary iliopsoas
       abscess, defined as being secondary to gastrointestinal or genitourinary
       causes or trauma, and seven patients with primary abscess, defined as
       the absence of the above causes. MAIN OUTCOME MEASURES: Patient
       characteristics, presenting symptoms and signs, microbiologic
       characteristics, treatment, and clinical course of patients with primary
       iliopsoas abscesses compared with those in patients with secondary
       abscesses. RESULTS: In the primary group, six patients (86%) were
       intravenous drug users and four (57%) were positive for human
       immunodeficiency virus. Staphylococcus aureus grew from cultures from
       five of seven patients with primary abscesses, whereas secondary
       abscesses had enteric flora. The typical patient presentation included
       fever, with complaints of pain in the flank, hip, or abdomen. Comparison
       of abscess drainage options showed shorter hospitalizations for surgical
       drainage than for percutaneous drainage (15.9 vs 28.5 days; P < or =
       .01). CONCLUSIONS: A patient who presents with pain in the flank, hip,
       or abdomen may have a primary iliopsoas abscess. Computed tomography is
       the standard method of diagnosis. Antibiotic regimens for patients with
       primary iliopsoas abscess should include coverage for S aureus, and
       patients with secondary abscesses should have antibiotic regimens
       tailored for enteric bacteria. Drainage of abscess is essential for
       appropriate treatment, and surgical drainage is superior to percutaneous
       drainage in achieving prompt recovery.
 DE    Adolescence  Adult  Aged  Aged, 80 and over  AIDS-Related Opportunistic
       Infections  Child  Child, Preschool  Drainage  Female  Human  Male
       Middle Age  *Psoas Abscess/DIAGNOSIS/MICROBIOLOGY/THERAPY  Retrospective
       Studies  Tomography, X-Ray Computed  Treatment Outcome  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

