M. TUBERCULOSİS VE S. AUREUS İLE KOMBİNE GELİŞMİŞ PSOAS ABSESİNİN BİR KOMPLİKASYONU OLARAK STAFİLOKOK PNÖMONİSİ

Öz

Gelişmiş ülkelerde nadir görülen psoas absesi, primer ve sekonder olarak sınıflandırılmaktadır. Sekonder psoas absesi Pott hastalığının bir komplikasyonu olarak görülürken, primer psoas absesinin en yaygın etkeni Staphylococcus aureus'tur. Artrit nedeniyle incelenirken, sepsis tablosu gelişen olgumuzda kan kültürü ile belirlenen stafilokok bakteriyemisine bağlı pnömoni gelişti. Psoas abse drenaj örneğinde ise asidorezistan basil (ARB) pozitif bulunan olgumuzu Mycobacterium tuberculosis ve Staphylococcus aureus kombinasyonu ile gelişmiş bir psoas absesi olarak tanımladık.

Anahtar Kelimeler

• Psoas absesi, M. tuberculosis, S. aureus

STAPHYLOCOCCAL PNEUMONIA AS A COMPLICATION OF THE PSOAS ABSCESS CAUSED BY M. TUBERCULOSIS AND S. AUREUS

Abstract

The psoas muscle abscess is a relatively uncomman clinical entity in industrialized countries which is classified as primary or secondary. Staphylococcus aureus is the most commonly recovered pathogen in primary psoas abscess. Secondary psoas abscess occurs as a result of complicated Potts disease. Pneumonia caused by staphylococcus bacteremia and left psoas muscle abscess was diagnosed in a 18 year old male patient who manifested with sepsis under investigation for artritis. The acid fast bacilli smear of the abscess drainage material was positive. We describe the case of a psoas abscess caused by the combination of Mycobacterium tuberculosis and Staphylococcus aureus.

Keywords

• Psoas abscess, M. tuberculosis, S. Aureus

Kaynakça

1. 1. Thomas A, Albert AS, Bhat S, Sunil KL. Primary psoas abscess-diagnostic and therapeutic considerations. Br J Urol 1996; 78: 358-60.
2. 2. Harrigan R, Kauffman F, Love M. tuberculous psoas abscess. J Emerg Med 1995; 13: 493–8.
3. 3. Ricci MA, Rose FB, Meyer KK. Pyogenic psoas abscess: worldwide variation in etiology. World J Surg 1986: 10: 834-6.
4. 4. Taiwo B. Psoas abscess: A primer for the internist: Case Report. South Med J 2001; 94: 78-80.
5. 5. Gruenwald I, Abrahamson J, Cohen O. Psoas abscess: Case report and review of the literature. J Urol 1992; 147: 1624–6.
6. 6. Chern CH, Hu SC, Kao WF, Tsai J, Yen D, Lee CH. Psoas abscess: making an early diagnosis in the ED. Am J Emer Med 1997; 15: 83-8.
7. 7. Huang Y. Tuberculous muscle abscess: an unusual presentation of tuberculosis. Am J Med 1990; 88: 57-9.
8. 8. Sinnott J, Cancio M, Frankle M, et al. Tuberculous osteomyelitis masked by concomitant staphylococcal infection. Arch Intern Med 1990; 150: 1865–7.

9. 9. Quereda C, Guerrero A, et al. Concomitant tuberculous and staphylococcal osteomyelitis. Am J Med 1991; 151: 2314.
10. 10. Numano¤lu N. Solunum Sistemi ve Hastal›klar›. Ankara Üniversitesi T›p Fakültesi Yay›nlar›. Ankara, 1997: 256-7.
11. 11. Navarro V, Meseguer V, Fernandez A, Medrano F, Saez JA, Puras A. Psoas muscle abscess. Description of a series of 19 cases. Enferm Infecc Microbiol Clin 1998; 16: 118-22.