Microbiology and outcome of iliopsoas abscess in 124 patients.
To describe the microbiology and outcome of iliopsoas abscess (IPA) in a large case series, we analyzed 124 cases of IPA collected from 1990 through 2004 in 11 hospitals in Spain. Twenty-seven (21.8%) patients had primary and 97 (78.2%) had secondary IPA. The main sources of infection were bone (50.5%), gastrointestinal tract (24.7%), and urinary tract (17.5%). A definitive microbial diagnosis was achieved in 93 (75%) cases. Abscess culture was the most frequent procedure leading to microbial diagnosis, followed by blood cultures. Staphylococcus aureus, Escherichia coli, and Bacteroides species were the most frequent microbial causes: S. aureus was the most common organism in patients with primary abscesses (42.9%) and with abscesses of skeletal origin (35.2%), whereas E. coli was the leading organism in those with abscesses of urinary (61.5%) and gastrointestinal (42.1%) tracts. Mycobacterium tuberculosis was found in 15 patients, 4 of them associated with human immunodeficiency virus (HIV) infection. Twenty (21.5%) cases had polymicrobial infections; these were more common among patients with abscesses of gastrointestinal origin. Information on clinical outcome was available for 120 patients; 19 (15.8%) had a relapse and 6 (5%) died due to complications related to the IPA. Patients who died were older and more likely to have bacteremia and E. coli isolated from cultures. In conclusion, secondary IPA is more prevalent than primary IPA. Among those with secondary IPA, most abscesses are secondary to a skeletal source. A bacterial etiology can be identified in most cases. The overall prognosis of patients with this condition is good.
López
Vicente Navarro
VN
From the Infectious Diseases Unit (VNL), Internal Medicine Department, Hospital de Torrevieja, Alicante; Infectious Diseases Unit (JMR, FG), Internal Medicine Department, Hospital General Universitario de Elche, Alicante; Internal Medicine Department (VM), Hospital General de Albacete, Albacete; Infectious Diseases Unit (JLPA), Internal Medicine Department, Hospital Insular de Gran Canaria, Gran Canaria; Internal Medicine Department (RS), Hospital del Henares, Coslada, Madrid; Internal Medicine Department (MAGO), Hospital de Antequera, Málaga; Internal Medicine Unit (GP), Hospital Sierrallana Torrelavega, Cantabria; Infectious Diseases Unit (VB), Hospital General de Alicante, Alicante; Infectious Diseases Unit (JP), Hospital Universitario de Salamanca, Salamanca; Internal Medicine Department (AC), Hospital Dr Negrin, Gran Canaria; Internal Medicine Department (FS), Hospital Serranía de Ronda, Malaga, Spain.
Ramos
José M
JM
Meseguer
Victoria
V
Pérez Arellano
José Luis
JL
Serrano
Regino
R
Ordóñez
Miguel Angel García
MAG
Peralta
Galo
G
Boix
Vicente
V
Pardo
Javier
J
Conde
Alicia
A
Salgado
Fernando
F
Gutiérrez
Félix
F
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000209:etiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001219:Aspartate Aminotransferases / Q000032:analysis; D016470:Bacteremia / Q000382:microbiology; D001439:Bacteroides / Q000302:isolation & purification; D001799:Blood Sedimentation; D001850:Bone Diseases, Infectious / Q000150:complications; D003402:Creatine Kinase / Q000032:analysis; D003424:Crohn Disease / Q000150:complications; D004238:Diverticulitis / Q000150:complications / Q000382:microbiology; D004322:Drainage; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000150:complications; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D007964:Leukocytosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D011379:Prognosis; D016659:Psoas Abscess / Q000175:diagnosis / Q000382:microbiology* / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013922:Thrombocytosis / Q000209:etiology; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000150:complications / Q000382:microbiology; D055815:Young Adult
D000900:Anti-Bacterial Agents; D001219:Aspartate Aminotransferases; D003402:Creatine Kinase