32. CLINICAL FEATURES AND RESULTS OF TREATMENT OF PSOAS ABSCESS AT NGUYEN TRI PHUONG HOSPITAL PERIOD 2018-2022
Main Article Content
Abstract
Background: Psoas muscle abscess is a rare medical condition. The clinical symptoms of a secondary psoas abscess are often atypical. This study aims to understand the pathological features to help diagnose and treat early cases of psoas abscess.
Objective: This study describes the clinical and paraclinical characteristics and treatment results of patients with iliopsoas abscesses undergoing intervention.
Methods: Retrospective descriptive study of patients who were diagnosed with psoas abscess and treated at Nguyen Tri Phuong Hospital from January 2018 to December 2022.
Results: In 29 patients, the mean age was 56,8 ± 14,8; ages 25 to 83 years old. Male accounted for 44,8%, female accounted for 55,2%, male:female ratio was 4:5. History of diabetes 65,5%, spondyloarthritis 31,0%. Fever was the most common reason for hospitalization (58,6%). The majority of psoas abscesses are on the right (62,1%), both sides are 6.9%. The result of pus culture was negative 55,2%, most positive for E. Coli (20,7%); There were 2 cases of PCR positive for TB (accounting for 6,9%). The two most used antibiotic regimens were Ceftriaxon + Metronidazole (31,3%) and Carbapenem + Linezolide (17,2%). After surgical intervention, leukocyte index and abscess volume decreased significantly (p<0,05). The average length of hospital stay was 19,7 ± 11,3 days.
Conclusion: Psoas abscess is a complicated disease with atypical clinical symptoms. Surgical drainage of the psoas abscess is important in resolving the infection. However, the treatment of psoas abscess usually involves a long hospital stay.
Article Details
Keywords
Psoas abscess, drainage surgery.
References
TPIliopsoas abscessesPostgraduate. Medical
Journal 2004;80:459-462.
[2] Rodrigues J, Iyyadurai R, Sathyendra S et al.,
Clinical presentation, etiology, management,
and outcomes of iliopsoas abscess from a tertiary
care center in South India. J Family Med Prim266
Care. 2017 Oct-Dec;6(4):836-839. doi: 10.4103/
jfmpc.jfmpc_19_17. PMID: 29564273; PMCID:
PMC5848408.
[3] Hsieh MS, Huang SC, Loh el-W et al., Features
and treatment modality of iliopsoas abscess and
its outcome: a 6-year hospital-based study. BMC
Infect Dis. 2013;13:578. Published 2013 Dec 9.
doi:10.1186/1471-2334-13-578
[4] Chern CH, Hu SC, Kao WF et al., Psoas abscess:
Making an early diagnosis in the ED. Am J
Emerg Med. 1997;15:83–8.
[5] Takada T, Terada K, Kajiwara H et al., Limitations
of using imaging diagnosis for psoas abscess in
its early stage. Intern Med; 2015;54:2589–93.
[6] Kimizuka Y, Ishii M, Murakami K et al.,
A case of skeletal tuberculosis and psoas
abscess: Disease activity evaluated using
(18)F-fluorodeoxyglucose positron emission
tomography-computed tomography. BMC Med
Imaging; 2013;13:37.
[7] Navarro López V, Ramos JM, Meseguer V et
al., Microbiology and outcome of iliopsoas
abscess in 124 patients. Medicine (Baltimore)
2009;88:120–30.
[8] Tabrizian P, Nguyen SQ, Greenstein A et al.,
Management and treatment of iliopsoas abscess.
Arch Surg; 2009;144:946–9.
[9] Gupta S, Suri S, Gulati M et al., Ilio-psoas
abscesses: Percutaneous drainage under image
guidance. Clin Radiol; 1997;52:704–7.