A late diagnosis of Pott’s disease in an adolescent with psoas abscess

Hacer Aktürk; Selda Hançerli Törün; Bahar Çalışkan; Oğuz Erol; Feryal Gün; Nuran Salman; Ayper Somer

doi:10.5472/MMJcr.2803.03

Research Article

Pott hastalığı sonrası psoas absesi gelişen bir adolesan olgu

Year 2015, Volume: 28 Issue: 3, 165 - 168, 28.11.2015

Hacer Aktürk , Selda Hançerli Törün Bahar Çalışkan Oğuz Erol Feryal Gün Nuran Salman Ayper Somer

https://doi.org/10.5472/MMJcr.2803.03

Abstract

Psoas abseleri altta yatan enfeksiyon odağının olup olmamasına
göre primer ve sekonder olarak sınıflandırılmaktadır. Sekonder
psoas abseleri daha sık görülür. Pott hastalığı olarak da bilinen
vertebra tüberkülozu psoas abselerinin önde gelen nedenlerinden
biridir. Bu yazıda, ilk olarak böğür ağrısı ve karında şişlik
yakınmaları gelişen 16 yaşındaki bir erkek hasta tanıtılmaktadır.
Bu yakınmaları takiben sırt ve karın bölgesinde kendiliğinden
akıntı gelişmiş ve nihayetinde ilk yakınmalardan yaklaşık 1 yıl
sonra sağ diz altı bölgesinde ağrı ve şişlik oluşmuştur. Hastaya,
akıntının spesifik kültüründe Mycobacterium tuberculosis üremesi
ve spinal MRI bulguları ile Pott hastalığına sekonder psoas absesi
tanısı konulmuştur. Pott hastalığına sekonder gelişen psoas
abselerinde kronik ve belirsiz klinik süreçler görülebilir. Bu durum
ise, hastamızda olduğu gibi tanıda gecikmeyle sonuçlanabilir.
Özellikle tüberkülozun endemik olduğu ülkelerde klinisyenlerin
bu nadir ve tanısı karışıklık yaratabilen hastalığı akılda tutmaları
gerekmektedir.

Keywords

Psoas absesi, Pott hastalığı, tüberküloz, Ayırıcı tanı

References

1. Mynter H. Acute psoitis, Buffalo Med Surg J 1881; 21: 202-10.
2. Turunç T, Turunç T, Demiroğlu YZ, Colakoğlu S. Retrospective evaluation of 15 cases with psoas abscesses. Mikrobiyol Bul 2009;43:121-5.
3. Altıntaş N, Türkeli S, Yılmaz Y, Sarıaydın M, Yaşayancan N. A rare case of tuberculosis psoas abscess. Eur J Gen Med 2012;9:159-61.
4. Janssens JP, De Haller R. Spinal tuberculosis in a developed country: A review of 26 cases with special emphasis on abscesses and neurologic complications. Clin Orthop 1990;257:67–75.
5. Maron R, Levine D, Dobbs TE, Geisler WM. Two cases of Pott’s disease associated with bilateral psoas abscesses: case report. Spine 2006 15;31:E561-64. doı: 10.1097/01. brs.0000225998.99872.7f
6. Nussbaum ES, Rockswold GL, Bergman TA, et al. Spinal tuberculosis: A diagnostic and management challenge. J Neurosurg 1995;83:243–47.
7. Pertuiset E, Beaudreuil J, Liote F, et al. Spinal tuberculosis in adults. A study of 103 cases in a developed country, 1980– 1994. Medicine 1999;78:309–20. 0025-7974/99/7805-0309/0
8. Berge VM, Marie S, Kuipers T, Jansz AR, Bravenboer B. Psoas abscess: report of a series and review of the literature. Neth J Med 2005;63:413-16.
9. Lopez VN, Ramos MJ, Meseguer V, et al. Microbiology and outcome of iliopsoas abscess in 124 patients. Medicine (Baltimore). 2009; 88:120-30. doı: 10.1097/ MD.0b013e31819d2748
10. Penado S, Espina B, Francisco Campo J. Abscess of the psoas muscle. Description of a series of 23 cases. Enferm Infecc Microbiol Clin 2001;19:257-60.
11. Van den Berge M, de Marie S, Kuipers T, Jansz AR, Bravenboer B. Psoas abscess: report of a series and review of the literature. Neth J Med 2005;63:413-16.
12. Santaella RO, Fishman EK, Lipsett PA. Primary vs. secondary iliopsoas abscess: presentation, microbiology and treatment. Arch Surg 1995;130:130913. doi:10.1001/ archsurg.1995.01430120063009
13. Zissin R, Gayer G, Kots E, Werner M, Shapiro-Feinberg M, Hertz M. Iliopsoas abscess: a report of 24 patients diagnosed by CT. Abdom Imaging 2001;26:533-39. doi: 10.1007/ s002610000201
14. Fitzgerald D, Haas DW. Mycobacterium tuberculosis. In: Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas, and Bennett’s: Principles and Practice of Infectious Diseases. 6th ed. Philadelphia: Elsevier Churchill Livingstone, 2005:2852–86.
15. Boxer DI, Pratt C, Hine AL, et al. Radiological features during and following treatment of spinal tuberculosis. Br J Radiol 1992;65:476–79. doi:http://dx.doi.org/10.1259/0007-1285- 65-774-476

A late diagnosis of Pott’s disease in an adolescent with psoas abscess

Year 2015, Volume: 28 Issue: 3, 165 - 168, 28.11.2015

Hacer Aktürk , Selda Hançerli Törün Bahar Çalışkan Oğuz Erol Feryal Gün Nuran Salman Ayper Somer

https://doi.org/10.5472/MMJcr.2803.03

Abstract

Psoas abscess is classified as primary or secondary according to
presence or absence of the underlying focus of infection. Secondary
psoas abscesses are much more common and tuberculosis of the
spine (Pott’s disease) is one of the leading predisposing diseases.
Here we report a 16-year-old male presented with flank pain and
abdominal distention, followed by spontaneous purulent drainage
from lower back and lower abdomen. Eventually a painful
swelling appeared below the right knee about one year after the
appearance of the first symptoms. He was diagnosed as Pott’s
disease and secondary psoas abscess based on specific culture
of draining pus, which yielded Mycobacterium tuberculosis and
spinal magnetic resonance imaging (MRI) findings. Psoas abscess
due to Pott’s disease may show a nonspecific and chronic clinical
course resulting in a late diagnosis and increased morbidity, as in
the reported case. Clinicians in the endemic countries should be
aware of this rare and challenging clinical entity

Keywords

Psoas abscess, Pott’s disease, tuberculosis, Differential diagnosis

References

1. Mynter H. Acute psoitis, Buffalo Med Surg J 1881; 21: 202-10.
2. Turunç T, Turunç T, Demiroğlu YZ, Colakoğlu S. Retrospective evaluation of 15 cases with psoas abscesses. Mikrobiyol Bul 2009;43:121-5.
3. Altıntaş N, Türkeli S, Yılmaz Y, Sarıaydın M, Yaşayancan N. A rare case of tuberculosis psoas abscess. Eur J Gen Med 2012;9:159-61.
4. Janssens JP, De Haller R. Spinal tuberculosis in a developed country: A review of 26 cases with special emphasis on abscesses and neurologic complications. Clin Orthop 1990;257:67–75.
5. Maron R, Levine D, Dobbs TE, Geisler WM. Two cases of Pott’s disease associated with bilateral psoas abscesses: case report. Spine 2006 15;31:E561-64. doı: 10.1097/01. brs.0000225998.99872.7f
6. Nussbaum ES, Rockswold GL, Bergman TA, et al. Spinal tuberculosis: A diagnostic and management challenge. J Neurosurg 1995;83:243–47.
7. Pertuiset E, Beaudreuil J, Liote F, et al. Spinal tuberculosis in adults. A study of 103 cases in a developed country, 1980– 1994. Medicine 1999;78:309–20. 0025-7974/99/7805-0309/0
8. Berge VM, Marie S, Kuipers T, Jansz AR, Bravenboer B. Psoas abscess: report of a series and review of the literature. Neth J Med 2005;63:413-16.
9. Lopez VN, Ramos MJ, Meseguer V, et al. Microbiology and outcome of iliopsoas abscess in 124 patients. Medicine (Baltimore). 2009; 88:120-30. doı: 10.1097/ MD.0b013e31819d2748
10. Penado S, Espina B, Francisco Campo J. Abscess of the psoas muscle. Description of a series of 23 cases. Enferm Infecc Microbiol Clin 2001;19:257-60.
11. Van den Berge M, de Marie S, Kuipers T, Jansz AR, Bravenboer B. Psoas abscess: report of a series and review of the literature. Neth J Med 2005;63:413-16.
12. Santaella RO, Fishman EK, Lipsett PA. Primary vs. secondary iliopsoas abscess: presentation, microbiology and treatment. Arch Surg 1995;130:130913. doi:10.1001/ archsurg.1995.01430120063009
13. Zissin R, Gayer G, Kots E, Werner M, Shapiro-Feinberg M, Hertz M. Iliopsoas abscess: a report of 24 patients diagnosed by CT. Abdom Imaging 2001;26:533-39. doi: 10.1007/ s002610000201
14. Fitzgerald D, Haas DW. Mycobacterium tuberculosis. In: Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas, and Bennett’s: Principles and Practice of Infectious Diseases. 6th ed. Philadelphia: Elsevier Churchill Livingstone, 2005:2852–86.
15. Boxer DI, Pratt C, Hine AL, et al. Radiological features during and following treatment of spinal tuberculosis. Br J Radiol 1992;65:476–79. doi:http://dx.doi.org/10.1259/0007-1285- 65-774-476

There are 15 citations in total.

Details

Primary Language	English
Subjects	Clinical Sciences
Journal Section	Case Reports
Authors	Hacer Aktürk Selda Hançerli Törün This is me Bahar Çalışkan This is me Oğuz Erol This is me Feryal Gün This is me Nuran Salman This is me Ayper Somer This is me
Publication Date	November 28, 2015
Published in Issue	Year 2015 Volume: 28 Issue: 3

Cite

APA	Aktürk, H., Hançerli Törün S., Çalışkan, B., Erol, O., et al. (2015). A late diagnosis of Pott’s disease in an adolescent with psoas abscess. Marmara Medical Journal, 28(3), 165-168. https://doi.org/10.5472/MMJcr.2803.03
AMA	Aktürk H, Hançerli Törün S, Çalışkan B, Erol O, Gün F, Salman N, Somer A. A late diagnosis of Pott’s disease in an adolescent with psoas abscess. Marmara Med J. December 2015;28(3):165-168. doi:10.5472/MMJcr.2803.03
Chicago	Aktürk, Hacer, Hançerli Törün Selda, Bahar Çalışkan, Oğuz Erol, Feryal Gün, Nuran Salman, and Ayper Somer. “A Late Diagnosis of Pott’s Disease in an Adolescent With Psoas Abscess”. Marmara Medical Journal 28, no. 3 (December 2015): 165-68. https://doi.org/10.5472/MMJcr.2803.03.
EndNote	Aktürk H, Hançerli Törün S, Çalışkan B, Erol O, Gün F, Salman N, Somer A (December 1, 2015) A late diagnosis of Pott’s disease in an adolescent with psoas abscess. Marmara Medical Journal 28 3 165–168.
IEEE	H. Aktürk, Hançerli Törün S., B. Çalışkan, O. Erol, F. Gün, N. Salman, and A. Somer, “A late diagnosis of Pott’s disease in an adolescent with psoas abscess”, Marmara Med J, vol. 28, no. 3, pp. 165–168, 2015, doi: 10.5472/MMJcr.2803.03.
ISNAD	Aktürk, Hacer et al. “A Late Diagnosis of Pott’s Disease in an Adolescent With Psoas Abscess”. Marmara Medical Journal 28/3 (December 2015), 165-168. https://doi.org/10.5472/MMJcr.2803.03.
JAMA	Aktürk H, Hançerli Törün S, Çalışkan B, Erol O, Gün F, Salman N, Somer A. A late diagnosis of Pott’s disease in an adolescent with psoas abscess. Marmara Med J. 2015;28:165–168.
MLA	Aktürk, Hacer et al. “A Late Diagnosis of Pott’s Disease in an Adolescent With Psoas Abscess”. Marmara Medical Journal, vol. 28, no. 3, 2015, pp. 165-8, doi:10.5472/MMJcr.2803.03.
Vancouver	Aktürk H, Hançerli Törün S, Çalışkan B, Erol O, Gün F, Salman N, Somer A. A late diagnosis of Pott’s disease in an adolescent with psoas abscess. Marmara Med J. 2015;28(3):165-8.