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Query: UMLS:C0000727 (acute abdomen)
 3,084 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The group B streptococcus is an opportunistic pathogen that causes a variety of serious infections including bacteremias, puerperal sepsis, and neonatal meningitis. Group B streptococcal infections of muscle are rare. We report here an unusual case of group B streptococcal pyomyositis. Pyomyositis arises predominantly from infections caused by Staphylococcus aureus and, occasionally, Streptococcus pyogenes. Because of the rarity of pyomyositis in temperate climates, the common lack of localizing signs or symptoms, and the frequently negative blood cultures, considerable delay often precedes the diagnosis of pyomyositis; in fact, the infection has been initially misdiagnosed as muscle hematoma, cellulitis, thrombophlebitis, osteomyelitis, or neoplasm. Diagnosis may be greatly aided by radiologic techniques that can demonstrate the sites of muscle enlargement and the presence of fluid collections. The response to antibiotics is usually rapid, but resolution of the infection may require aspiration of deeply situated muscle abscesses. This report describes a diabetic patient with an unusual presentation of pyomyositis that mimicked an acute abdomen.
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PMID:A case of group B streptococcal pyomyositis. 204 67

Inflammatory irritation of the psoas muscle in children is rare. The initial diagnosis may be difficult because of the similarity between the symptoms of psoas muscle inflammation and septic hip joint. We present a boy and a girl, both 3.5 years old, with psoas muscle inflammation, whose initial clinical and laboratory findings could be explained by either septic hip joint or osteomyelitis. Both presented with fever and limp. 1 developed an acute abdomen within 3 days and at operation a retrocecal periappendicular abscess was found. In the other, left lower quadrant, abdominal pain developed 4 days following admission and ultrasonic findings indicated a left psoas muscle abscess. We suggest that psoas muscle inflammation should be added to the differential diagnosis of limp in children. Early correct diagnosis can be established by proper physical examination, including rectal examination, and with the aid of diagnostic tools such as ultrasound, computerized tomography or both.
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PMID:[Limp as a presenting symptom of psoas muscle inflammation]. 268 Aug 17

Because bleeding into the rectus sheath may give a clinical picture simulating an acute abdomen, it is essential that an accurate diagnosis be made so that an unnecessary laparotomy is not performed. Plain films do not give adequate information and computerized axial tomography is not always available, but ultrasonography, which is noninvasive and is readily available, provides an accurate diagnosis as in the case reported in this paper. A 57-year-old woman had bilateral hematomas of the rectus sheath that did not occur simultaneously. She had a chronic debilitating disease as do the majority of such patients. Long-term cortisone therapy with secondary breakdown of connective tissue was probably the predisposing factor. During a blood transfusion that was needed following operation for osteomyelitis the patient had a severe reaction accompanied by sudden onset of severe abdominal pain on the left side. Ultrasonography confirmed the tentative diagnosis of rectus sheath hematoma. The patient was treated conservatively. The pain subsided within a few days leaving an ecchymosis. Two weeks later she experienced a similar pain on the right side which was also diagnosed by ultrasonography as a rectus sheath hematoma. Again, with conservative treatment the pain subsided leaving discolouration of the skin. The authors stress the value of ultrasonography in diagnosing rectus sheath hematoma and the importance of conservative management.
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PMID:Ultrasonography in the diagnosis of rectus abdominis hematoma. 645 3

A 67-year-old woman was admitted with diffuse lower abdominal and suprapubic pain, with diastasis of the pubic symphysis. She developed an acute abdomen necessitating an exploratory laparotomy. During laparotomy, the pubic lesion was explored, and histology confirmed the diagnosis of pubic osteomyelitis and the presence of Staphylococcus aureus. The patient recovered fully with a four-week course of antibiotic therapy. This case confirms the protean presentation of pubic osteomyelitis, alerting physicians of the necessity to institute prompt treatment is such cases.
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PMID:Acute abdomen: an atypical presentation of pubic osteomyelitis. 877 Apr 52

Patients with systemic lupus erythematosus (SLE) are prone to infection. Immunomodulation treatment increases the susceptibility. Salmonella infections in SLE patients may present with various clinical pictures, like pneumonia, septic arthritis, osteomyelitis, peritonitis, abscess and so on. The vascular complications commonly seen in the general population with salmonella infection are rarely encountered in SLE patients. Here we report an SLE patient who presented with spontaneous rupture of salmonella mycotic aneurysm involving the left renal artery. The 54 year-old woman had a stable premorbid condition and had 30 mg prednisolone per day. Acute abdomen and hypotensive shock developed suddenly without warning signs in advance. Image and tissue culture confirmed the diagnosis. The patient had an uneventful recovery. The rare clinical scenario is reported.
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PMID:Rupture of renal artery aneurysm due to Salmonella infection in a patient with systemic lupus erythematosus. 1825 Jan 38

Three patients who came to the surgical outpatient department of 'Postgraduate Institute of Medical Education and Research', Chandigarh, India with features suggestive of acute abdomen are presented. On thorough evaluation, they had bilateral psoas abscess and on detailed investigations, tuberculosis was found to be the etiological factor. They were treated conservatively with good follow-up results. Psoas abscess may be clinically difficult to diagnose because of its rarity, insidious onset of the disease, and non-specific clinical presentation which can cause diagnostic delays resulting in high morbidity. Early diagnosis and appropriate management remains a challenge for clinicians. All three patients presented here have recovered following detailed investigation and appropriate management. The diagnosis of spinal tuberculosis should be considered in patients with vertebral osteomyelitis, psoas abscess, and appropriate risk factors such as a history of previous exposure in both developed and developing countries, as tuberculosis is re-emerging as an important etiological factor in spinal pathologies.
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PMID:Bilateral psoas abscess: atypical presentation of spinal tuberculosis. 2242 47