[Iliopsoas abscess: therapeutic approach and outcome in a series of 35 patients]

Enferm Infecc Microbiol Clin. 2012 Jun;30(6):307-11. doi: 10.1016/j.eimc.2011.09.016. Epub 2011 Dec 1.
[Article in Spanish]

Abstract

Introduction: The present study was aimed at reviewing the iliopsoas abscess (IPA) from a contemporary perspective, on the basis of experience from two tertiary referral centres.

Material and methods: We performed a retrospective analysis of 35 cases of IPA diagnosed between 1998 and 2009. Their clinical and microbiological features were recorded, as well as their long-term outcome according to the type of treatment: antibiotics alone (10 patients), or antibiotics plus percutaneous drainage or surgery (25 patients).

Results: Primary abscess occurred in 8 patients. The most frequent source of secondary abscesses was spondylodiscitis. The classic clinical triad (fever, pain and functional impairment) was present in 10 patients, with a median duration of symptoms before diagnosis of 12 days. Staphylococcus aureus was the most frequently isolated microorganism. At the end of a median follow-up of 454 days, the risk of poor outcome (related death and/or relapse) was higher among patients with diabetes mellitus (44.4% vs. 7.7%; P=.027), with no significant differences according to the therapeutic approach (20.0% in the group of antibiotics alone vs. 28.0% in the group with drainage or surgery).

Conclusions: In our series, most cases of IPA were due to S. aureus and secondary to a skeletal source. Antibiotic therapy seems effective in the long-term, although diabetic patients had a higher risk of relapse.

Publication types

  • English Abstract
  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Combined Modality Therapy
  • Comorbidity
  • Diabetes Complications / drug therapy
  • Diabetes Complications / epidemiology
  • Diabetes Complications / microbiology
  • Diabetes Complications / surgery
  • Discitis / complications
  • Discitis / microbiology
  • Drainage
  • Enterobacteriaceae Infections / drug therapy
  • Enterobacteriaceae Infections / epidemiology
  • Enterobacteriaceae Infections / surgery
  • Female
  • Hospitals, University / statistics & numerical data
  • Humans
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / epidemiology
  • Male
  • Middle Aged
  • Prognosis
  • Psoas Abscess / drug therapy
  • Psoas Abscess / epidemiology
  • Psoas Abscess / microbiology
  • Psoas Abscess / surgery
  • Psoas Abscess / therapy*
  • Recurrence
  • Retrospective Studies
  • Spain / epidemiology
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / surgery
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents