A Case of an 80-Year-Old Man with Empyema and Psoas Abscess.

Case Reports in Emergency Medicine Pub Date : 2020-10-24 eCollection Date: 2020-01-01 DOI:10.1155/2020/8895785
Mikio Sakurai, Hiroki Nagasawa, Ikuto Takeuchi, Youichi Yanagawa
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引用次数: 4

Abstract

An 80-year-old man with flu symptoms collapsed at his house and had a backache worsened over time. His family called for an ambulance. On arrival, chest X-ray showed reduced permeability of the right lung field, and truncal computed tomography (CT) suggested right multilobular empyema and right iliopsoas abscess. A blood test showed an acute inflammatory response. The patient underwent right small thoracotomy for empyema and ultrasonic-guided drainage for the right iliopsoas abscess and started the administration of antibiotics. We started the administration of doripenem by intravenous drip and then deescalated to ampicillin based on the culture results. Streptococcus intermedius was cultured from all sites. Following these treatments for three months, his general condition improved. We herein report a unique case of complicated empyema and iliopsoas abscess in which a favorable outcome was obtained by an appropriate diagnosis and treatment. Reports of multiple abscesses have been increasing recently because of the growing geriatric population and aging-related complications. It is important to search the whole body to detect multiple abscesses in cases where an abscess is detected at a single site.

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80岁男性脓胸及腰肌脓肿1例。
一名有流感症状的80岁男子在家中昏倒,背部疼痛随着时间的推移而加剧。他的家人叫了救护车。到达时,胸部x线显示右肺野通透性降低,CT提示右侧多小叶脓肿和右侧髂腰肌脓肿。血液检查显示急性炎症反应。患者行右侧小胸开胸术治疗脓胸,超声引导下引流右侧髂腰肌脓肿,并给予抗生素治疗。我们开始静脉滴注多利培南,然后根据培养结果逐步升级为氨苄西林。各部位均培养中间链球菌。经过三个月的治疗,他的总体情况有所改善。我们在此报告一个独特的病例,复杂的脓肿和髂腰肌脓肿,在适当的诊断和治疗获得了良好的结果。由于老年人口的增长和与衰老相关的并发症,最近多发性脓肿的报道一直在增加。在单个部位发现脓肿的情况下,检查全身以发现多个脓肿是很重要的。
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