[Presacral phlegmons and meningitis as the complications of a foreign body in the rectosigmoid].
A 24-year-old patient presented with severe back pain in the lumbar and sacral regions and septic temperatures up to 40 degrees C. Lasègue's sign was bilaterally positive. An enhanced cell count was seen in the CSF (1877 cells/microliters, erythrocytes 1024/microliters). Total protein concentration was 4440 mg/dl. The patient also suffered from granulocytic pleocytosis. X-ray as well as scintigrams revealed inflammation of the presacral soft parts involving the os sacrum and bone marrow. Treatment with doxycycline (200 mg/d), fosfomycin (5 g/d), netilmicin (400 mg/d) and ofloxacin (200 mg/d) succeeded in curing the meningitis, whereas the presacral phlegmon persisted. Endoscopic examination showed a rod-shaped foreign body in the rectum that had penetrated deeply into the mucosa and required deformation and removal by laser. The plastic rod of 10 cm length was probably a liquorice stick. The patient denied introducing it per anum; he suspected having swallowed it while drunk. The inflammation subsided rapidly after removal of the foreign body.
Medizinische Klinik I mit Poliklinik, Universität Erlangen.
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Nusko
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Dertinger
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Cidlinsky
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Ell
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Hahn
D000328:Adult; D002481:Cellulitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012809:Colon, Sigmoid / Q000601:surgery; D003113:Colonoscopy; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005547:Foreign Bodies / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008161:Lumbosacral Region; D008297:Male; D008581:Meningitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012007:Rectum / Q000601:surgery
Präsakrale Phlegmone und Meningitis als Komplikationen eines Fremdkörpers im Rektosigmoid.