Iliopsoas Abscess in Hemodialysis Patients With End-Stage Kidney Disease

Ther Apher Dial. 2019 Dec;23(6):534-541. doi: 10.1111/1744-9987.12801. Epub 2019 Apr 25.

Abstract

Iliopsoas abscess in HD patients is rare. We examined nine HD patients with iliopsoas abscess (six men and five diabetes mellitus cases) treated between 2005 and 2015. Mean age and dialysis vintage at onset were 72 years and 109 months, respectively. Of the nine patients, four had lumbar orthopedic diseases, and two had all components of the classic triad of iliopsoas abscess at onset. All nine patients underwent percutaneous drainage, while seven underwent antimicrobial therapy. The most common pathogenic bacterium was methicillin-resistantStaphylococcus aureus(MRSA) (n = 5). Four patients had multilocular recurrence on the same side as the initial abscess and did not undergo CT before drainage catheter removal. Five patients died in the hospital, in which three died due to infectious diseases by MRSA. We suggest percutaneous drainage as the first-line therapy for HD patients with iliopsoas abscess and recommend combining antimicrobial therapy for MRSA, because of poor prognosis.

Keywords: Antimicrobial therapy; Drainage; Hemodialysis; Iliopsoas abscess; Methicillin-resistant Staphylococcus aureus.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / administration & dosage
  • Drainage / methods
  • Female
  • Humans
  • Kidney Failure, Chronic / therapy*
  • Male
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification
  • Middle Aged
  • Psoas Abscess / microbiology
  • Psoas Abscess / therapy*
  • Renal Dialysis*
  • Retrospective Studies
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / microbiology
  • Staphylococcal Infections / therapy

Substances

  • Anti-Bacterial Agents