A 5-year-old girl was admitted to the day care center due to a febrile seizure (T 39oC), on the 5th day of chickenpox.
He recovered rapidly from his febrile seizure, without neurological signs or symptoms to highlight.
The patient reported, for two days, pain in the lumbar fossa with functional impotence of the lower limbs and restlessness.
• Left hip extension pain. • Left lower limb in antalgic position ( thigh flexion).
Laboratory: • GB: 18 800 (with neutrophilic predominance [78%]). • ERS: 70 mm/h. • PPD: negative. • HIV serology: negative.
Radiology: • Thoracic, lumbosacra and hip without pathological images.
A CT scan was requested with a presumptive diagnosis of spondylodyscitis or psoas abscess.
The report describes a hypodense image in the left psoas muscle, compatible with psoas abscess.
1.
Surgical drainage culture: Oxacillin-resistant Staphylococcus aureus.
susceptible to rifampicin, clindamycin, vancomycin, and trimethoprim-sulfametoxasol.
The treatment consisted of surgery with left transverse incision at the level of the iliac crest.
A suppuration area corresponding to the psoasiliac space is observed; 15 ml of thick pus are drained, which is sent to culture and the bed is washed.
Cclindamycin was administered at 40 mg/kg/day + gentamicin at 5 mg/kg/day IV for 8 days, then continued treatment with oral clindamycin until completing 6 weeks.
The patient responded well to antibiotic-surgical treatment, with clinical and laboratory improvement.
