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2017 ; 18
(ä): 395-398
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Giant Iliopsoas Abscess Caused by Morganella Morganii
#MMPMID28404984
Nakajima M
; Shirokawa M
; Miyakuni Y
; Nakano T
; Goto H
Am J Case Rep
2017[Apr]; 18
(ä): 395-398
PMID28404984
show ga
BACKGROUND While uncommon, iliopsoas abscesses can become the underlying cause of
a fever of unknown origin. Even in such cases, it is considered rare for an
iliopsoas abscess to extend into the subcutaneous space. CASE REPORT A
74-year-old woman with a history of schizophrenia was referred to our hospital
with a high-grade fever. The patient was unaware of her febrile status prior to
admission. There was no previous hospital admission. Examination revealed a
non-tender mass in the lower right back that the patient had been aware of for
approximately 1 month. Initially, we considered a subcutaneous abscess; however,
computed tomography (CT) detected a large mass in the right retroperitoneum,
which extended into the adjacent subcutaneous space. Surgical drainage was
performed. M. morganii was detected in fluid evacuated from the abscess and in a
urine culture. Blood cultures were negative. A repeat enhanced CT revealed a
right renal abscess with staghorn calculus. This iliopsoas abscess was considered
to be due to a renal abscess. The combination of a minimally aggressive bacterial
species and the absence of disease awareness resulted in uncontrolled abscess
growth in this case. Surgical drainage and salvage nephrectomy was subsequently
performed, and she was discharged to a nursing home. CONCLUSIONS M. morganii can
lead to massive abscess formation without an underlying immunocompromised status.
Iliopsoas abscesses can surreptitiously extend into the subcutaneous space;
therefore, not all abscesses observable from the surface are necessarily
subcutaneous in origin.
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