Gluteal abscess causing sciatica in a patient with systemic lupus erythematosus.
Low back pain and sciatica may be caused by pathology remote from disc and lumbosacral vertebral segments. We report on a 59-year-old patient with systemic lupus erythematosis whose history illustrates this point. The patient was evaluated and diagnosed to have a septic arthritis of the wrist and lumbar spinal stenosis, for which she was treated. The patient's failure to respond to therapy led to further evaluation. A massive gluteal abscess was identified and drained, and with appropriate antibiotic therapy, the patient recovered. Patients with lupus have increased likelihood of infection, and their evaluation should include a search to discover unusual locations in cases that are unresponsive to standard and seemingly appropriate therapy.
Shames
J L
JL
Department of PM&R, Nassau County Medical Center, East Meadow, NY 11554.
Fast
A
A
D000038:Abscess / Q000150:complications* / Q000000981:diagnostic imaging; D002081:Buttocks; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008875:Middle Aged; D009135:Muscular Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D012585:Sciatica / Q000209:etiology*; D014057:Tomography, X-Ray Computed