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Slike u infektivnim bolestima: Apsces m. psoasa uzrokovan izvanbolnički stečenim meticilin- rezistentnim zlatnim stafilokokom u bolesnika sa spondilodiscitisom

Psoas abscess is a rather rare entity characterized by collection of pus in the iliopsoas muscle compartment. It can occur as a result of contiguous spread from adjacent structures (i.e. osteomyelitis, spondylodiscitis, renal abscess) or by the hematogenous spread from a distant site. The most common pathogen is Staphylococcus aureus, including (MRSA). Other pathogens include enteric bacteria (E. coli, Kl. pneumoniae), streptococci and tuberculosis in areas where it is common. Clinical features include back or flank pain, pain radiating to hip or leg, fever, limp, limitation of hip movement (pain on hip extension). The diagnosis should be confirmed by imaging modalities. MRI is considered to be the primary imaging modality recommended by the Infectious Diseases Society of North America (IDSA) because of its high sensitivity and specificity (97 % and 93 % respectively). The sensitivity and specificity of the CT is lower (67 % and 50 %, respectively) but it has a superior ability to detect necrotic bone (sequestrum) and intramedullary and soft tissue gas when compared to MRI. CT is strongly recommended in patients who are unable to undergo MRI because of the metal and electronic implants. Blood cultures and abscess material can help in determining the etiology of psoas abscess.

Abscess m. psoasa

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