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Posterior Approach for Debridement of the Psoas Abscess
Published on: March 2, 2020
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[Psoas abscess and lumbar spine osteomyelitis: case report]
Ana M Silva1, Lauwence A Schmalbach2
1Servicio de Pediatría. Hospital Central de Pediatría Dr. Claudio Zin, Malvinas Argentinas, Buenos Aires. ana_maria_silva@live.com.
Archivos Argentinos De Pediatria
|September 9, 2016
Summary
Psoas abscess, a common pediatric condition, can present subtly. This case highlights methicillin-resistant Staphylococcus aureus (MRSA) causing vertebral infiltration, requiring prompt diagnosis and treatment.
Area of Science:
- Pediatric Infectious Diseases
- Musculoskeletal Infections
- Radiology
Background:
- Psoas abscess is a recognized pediatric condition, often presenting with nonspecific symptoms.
- Primary psoas abscesses are more common in children, but secondary origins linked to severe infections like osteomyelitis necessitate high clinical suspicion.
Observation:
- A 14-year-old male, previously healthy, presented with an unusual psoas abscess infiltrating the L2 vertebral body.
- Initial X-ray and ultrasound were inconclusive; diagnosis was confirmed via magnetic resonance imaging (MRI) of the lumbosacral spine.
Findings:
- Blood cultures were positive for methicillin-resistant Staphylococcus aureus (MRSA).
- The patient received 2 weeks of intravenous and 4 weeks of oral antibiotic therapy.
- Treatment resulted in blood culture negativization and complete symptom resolution.
Implications:
- This case underscores the importance of advanced imaging like MRI for diagnosing complex pediatric psoas abscesses, especially with vertebral involvement.
- Prompt identification and targeted antibiotic therapy, including for MRSA, are crucial for successful outcomes in pediatric vertebral osteomyelitis secondary to psoas abscess.
- Early detection and management can prevent long-term complications associated with spinal infections in children.
