Presentation
A 67-year-old man presented with abdominal pain, sub-occlusion, left groin mass, left groin, and lower limb pain during walking, negative Blumberg sign. [ncbi.nlm.nih.gov]
We are presenting a 33 year old newly diagnosed diabetic patient who presented initially with fever, pain in right loin region and burning micturition since 1 week. Patient also took care of pain during defecation. [ijsurgery.com]
Entire Body System
- Fever
The authors define an unexplained fever as a fever which lasts a minimum of 14 days and whose etiology is not known. [books.google.de]
Disseminated mycobacterial infection after Bacille Calmette-Guérin (BCG) vaccination is a rare disorder, usually presenting with fever, weight loss, anemia, lymphadenopathy and hepatosplenomegaly. [ncbi.nlm.nih.gov]
- Malaise
Two weeks later, fever, malaise, and pneumaturia developed and urine culture grew Escherichia coli. Laparotomy revealed a large occult retroperitoneal abscess on the left side, which had been irritating the psoas muscle. [ncbi.nlm.nih.gov]
It includes : Abdominal pain or flank pain Pain in the groin, hip or referred pain to the knee in a psoas abscess Fever with chills Weakness and malaise Loss of weight Please note that any information or feedback on this website is not intended to replace [healthhype.com]
Other symptoms are nausea, malaise and weight loss. Psoas muscle abscess may be classified as primary or secondary depending on the presence or absence of underlying disease. [radiopaedia.org]
Eight weeks after the biopsy she presented with left flank pain, malaise and fever. There was a tender subcutaneous induration over the biopsy site. [bmcnephrol.biomedcentral.com]
Specific symptoms of abdominal abscesses depend on the location of the abscess, but most people have constant discomfort or pain, feel generally sick (malaise), and often have a fever. [msdmanuals.com]
- Weakness
Failure in eliminating the primary infective focus could bring complications and, in general, a weakness of lumbar muscular wall, even resulting in a rare case of lumbar hernia. [ncbi.nlm.nih.gov]
It includes : Abdominal pain or flank pain Pain in the groin, hip or referred pain to the knee in a psoas abscess Fever with chills Weakness and malaise Loss of weight Please note that any information or feedback on this website is not intended to replace [healthhype.com]
You may have: Swollen belly Diarrhea Fever or chills Lack of appetite and possible weight loss Nausea or vomiting Weakness Cough Your symptoms can be a sign of many different problems. [medlineplus.gov]
[…] third to sixth decades of life, with a slightly higher predominance in males. (3) Patients present with an insidious onset of a chronic debilitating illness and generalized symptoms of a serious infection including flank, abdominal, and groin pain, weakness [thefreelibrary.com]
Fever with chills and general weakness are common symptoms. Flank pain and abdominal pain are also common, and pain may be referred to the groin or leg (7,9). Renal ultrasonography and CT scan are the diagnostic methods of choice (11). [apm.amegroups.com]
- Fatigue
A 71-year-old man presented with pain in his left side, fatigue, fever, nausea, massive subcutaneous emphysema of the neck, and Blumberg sign in the left iliac fossa. [ncbi.nlm.nih.gov]
A 63-year-old man with diabetes mellitus,renal failure and neurogenic bladder was hospitalized complaing of general fatigue and a poor appetite. [webview.isho.jp]
Definite and early fatiguing. May have occasional arrests in movement. 3 = Severely impaired. Frequent hesitation in initiating movements or arrests in ongoing movement. 4 = Can barely perform the task. Seite 298 - Examinations: 18. [books.google.de]
Physical Exam General Appearance The patient is usually fatigued & looking ill due to the preexisting risk factor. [wikidoc.org]
- Inguinal Pain
Her clinical debut began with left inguinal pain and an irreducible mass at this level that simulated an incarcerated inguinal hernia, which is why surgery was indicated. [ncbi.nlm.nih.gov]
Gastrointestinal
- Abdominal Pain
A fatal case of appendicitis in a 76-year-old man who presented with progressive abdominal pain, retroperitoneal abscesses and extensive subcutaneous emphysema, is described. [ncbi.nlm.nih.gov]
- Abdominal Tenderness
Abdominal examination revealed distension of abdomen, diffuse abdominal tenderness along with guarding, rigidity and absent bowel sounds. Decreased air entry in the mid and lower zone of the left lung was noted. Total leucocyte count was 18,700/µL. [ispub.com]
In advanced cases with septicemia, the patient may be drowsy with decreased level of consciousness.[1] Vital signs Fever Tachycardia Tachypnea Hypotension (if patient is presenting with shock) Abdominal Examination Abdominal tenderness is often present [wikidoc.org]
Skin
- Night Sweats
Case 3 : A 19 year old male presented with high grade fever with rigors, night sweats, vomiting and a constant dull ache in the right lumbar region of 20 days duration. [jpma.org.pk]
Workup
The most frequently used image modality for the initial workup of patients with abdominal discomfort is supine abdominal radiography (kidneys, ureters, and bladder [KUB]). [tcmjmed.com]
Her initial workup was directed towards identifying an infective focus and a pathogen causing the infection. Diagnostic sensitivity of ultrsonography for retroperitoneal abscesses is 67%–87%. [hindawi.com]
(See Workup, Computed Tomography.) Sequential, multiple organ failure is the main cause of death. [emedicine.medscape.com]
X-Ray
- X-Ray Abnormal
Abscesses near the diaphragm may result in chest x-ray abnormalities such as ipsilateral pleural effusion, elevated or immobile hemidiaphragm, lower lobe infiltrates, and atelectasis. CBC and blood cultures should be done. [merckmanuals.com]
Serum
- Neutrophilia
Laboratory values revealed leukocytosis (34,000 to 64,000) with neutrophilia and thrombocytopenia. Electrolytes and renal parameters were normal initially but became deranged as sepsis progressed. [cureus.com]
Microbiology
- Staphylococcus Aureus
Abstract Glenohumeral septic arthritis is rare and usually a result of Staphylococcus aureus infection. Gram-negative septic arthritis is on the increase and is usually associated with intraabdominal pathology. We present a case of bilateral E. [ncbi.nlm.nih.gov]
Results: In case 1, Staphylococcus aureus was found in cultures from abscess pus, and in case 2 from umbilical pus, abscess purulent material and blood. Both infants are in good health after a follow‐up of 6 mo and 8 y, respectively. [onlinelibrary.wiley.com]
Most common pathogens Staphylococcus aureus Streptococcus sp. Enterobacteriaceae Citrobacter sp. Escherichia coli Klebsiella Proteus sp. Pseudomonas aeruginosa Serratia Anaerobes Actinomyces Peptostreptococcus Bacteroides fragilis Prevotella sp. [unboundmedicine.com]
Laboratory
- Leukocytosis
Laboratory studies showed leukocytosis (WBC=18000) and an ubnormal liver function tests (AST=91U/l, ALT=122U/l, ALP=277U/l). A computed tomography of the abdomen revealed a retroperitoneal abscess, while the abdominal viscera were normal. [annalsgastro.gr]
Laboratory studies showed leukocytosis with a shift to the left and pyuria. A contrast-enhanced CT of the abdomen was performed in order to determine the origin of the clinical and laboratory findings. [eurorad.org]
Lab Findings Classic lab findings of inflammation as leukocytosis, high ESR, high CRP ,etc, ...Leukocytosis is usually not extremely high (between 10,000 and 20,000 in most cases) Blood culture is not always positive (but carries a grave prognosis if [wikidoc.org]
Laboratory results usually reveal leukocytosis, with a polymorphonuclear predominance. [thefreelibrary.com]
Our patient presented without leukocytosis, lactic acidosis or significant fever. His predominant symptom was back and flank pain. This further highlights the insidious presentation of retroperitoneal abscesses. [jcol.elsevier.es]
Treatment
INTRODUCTION: This study examined the risk factors for initial treatment failure in renal or retroperitoneal abscess as a multicenter study. [ncbi.nlm.nih.gov]
Prognosis
This case highlights this unusual initial presentation of right colonic cancer, the diagnostic dilemma and the poor prognosis associated with it. [ncbi.nlm.nih.gov]
Renal Failure DVT Small Bowel Obstruction Arterial Thrombosis UTI Brain abscess Empyema Osteomyelitis Prognosis Depending on the extent of the abscess at the time of diagnosis, the prognosis may vary. [wikidoc.org]
Treatment and prognosis Appropriate antibiotics along with drainage of the abscess are the treatment of choice. [radiopaedia.org]
ERCP-associated perforation is a rare complication and can be challenging to diagnose and treat; prompt recognition is mandatory for favorable prognosis. Our patient was managed successfully via nonsurgical approach. 1. [hindawi.com]
No imaging technique will improve the prognosis for retroperitoneal necrotizing fasciitis unless it is coupled with a high degree of clinical awareness and early surgical intervention. [cureus.com]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
The authors define an unexplained fever as a fever which lasts a minimum of 14 days and whose etiology is not known. [books.google.de]
We report the case of a 77-year-old woman who presented with fever of unknown etiology and a complication of retroperitoneal abscess mimicking a gluteal abscess with gallstones and clips the abscess. [ncbi.nlm.nih.gov]
Pediatric Considerations Consider necrotizing enterocolitis as an etiology in newborns. [unboundmedicine.com]
Epidemiology
[…] transverse mesocolon Perirenal space Kidneys, renal vessels, adrenal glands Posterior pararenal space Contains no major organs and is filled with fat, blood vessels, and lymphatics Bounded by renal fascia and the muscles of the posterior abdominal wall Epidemiology [unboundmedicine.com]
Kline MW, Mason EOJR, Kaplan SL: Epidemiologic marker system for Citrobacter diversus using outer membrane protein profiles. J Clin Microbiol 1989;27:1793–1796. [karger.com]
Epidemiology Epidemiologic data are limited because of the low incidence of retroperitoneal infections. [liebertpub.com]
Retroperitoneal hematoma ✔ Anemia Retroperitoneal tumors (.e.g. liposarcoma) ✔ ✔ ✔ Positive tumor marker Chronic pancreatitis ✔ ✔ Elevated blood sugar (due to diabetes mellitus), amylase and lipase levels may be slightly elevated Epidemiology and demographics [wikidoc.org]
Pathophysiology
This book covers pathophysiology of fever, the general approach to the febrile patient, and offers a systematic, in-depth discussion regarding the differential diagnosis of unexplained fever. [books.google.de]
These cases show that knowledge of the anatomy of the retroperitoneal space is important to establish the suspicion of an abscess, to understand its manifestations, which are sometimes caused by a rare pathophysiology, and to initiate appropriate treatment [ncbi.nlm.nih.gov]
Bounded by renal fascia and the muscles of the posterior abdominal wall Epidemiology Incidence Most common in the 3rd to 6th decades (1) Slight male predominance (1) Prevalence Rare condition in which perirenal abscesses are more common (2) Etiology and Pathophysiology [unboundmedicine.com]
[…] abscess may be classified according to the location in the retroperitoneal space into 5 categories [1] : Perinephric abscess Upper retroperitoneal abscess Pelvic abscess Combined retroperitoneal and pelvic abscess Lٍٍocalized musculoskeletal abscess Pathophysiology [wikidoc.org]
Prevention
Treatment of the primary disease Prevention of infection, such as perioperative antibiotic prophylaxis Prompt treatment of symptomatic infection Commonly Associated Conditions Bowel perforation Diabetes mellitus Diverticulitis Immunosuppression (HIV, [unboundmedicine.com]
Prompt recognition, early surgical intervention, and optimal use of antibiotics can reduce morbidity and prevent death. [ncbi.nlm.nih.gov]
The amputated calyx is carefully ligated with a 4-0 chromic catgut suture to prevent urinary fistula or urinoma formation. [urologysurgery.wordpress.com]
Rapid epithelialization of skin puncture site following biopsy will prevent continued entry of organisms in to deeper tissue planes. [bmcnephrol.biomedcentral.com]
An early ultrasound and drainage in this case may have prevented fistulation of the retroperitoneal abscess through the abdominal wall. Occult retroperitoneal abscess presenting as septic arthritis of the hip. [medical-dictionary.thefreedictionary.com]