Postpartum iliopsoas pyomyositis due to community-acquired methicillin-resistant Staphylococcus aureus
ABSTRACT Community-acquired, methicillin-resistant Staphylococcus aureus (MRSA) infections are on the rise among patients without risk factors for resistant microorganisms. A new, serious community-acquired MRSA manifestation, postpartum iliopsoas pyomyositis is described.
A 24-year-old Hispanic female presented with back pain 9 days after a normal vaginal delivery. Magnetic resonance imaging showed extensive ill-defined edema of the left iliopsoas. Blood cultures yielded community-acquired MRSA. The patient received intravenous vancomycin for 6 days, followed by intravenous, then oral, trimethoprim-sulfamethoxazole. She was discharged on day 8 and made a full recovery.
Iliopsoas pyomyositis is a new manifestation of community-acquired MRSA in the obstetric population that may masquerade as benign musculoskeletal back pain. Obstetricians must be alert to the range of presentations of this emerging pathogen.
SourceAvailable from: Sanitra Anuwutnavin[Show abstract] [Hide abstract]
ABSTRACT: Abstract Background: Retroperitoneal infection can be lethal. Optimal management is still elusive to describe because of the small number of case reports. We presented here a case of retroperitoneal abscess caused by Clostridium difficile arising in the puerperal period. Methods: Case report and review of recent English-language literature. Results: The patient presented with surgical incision dehiscence. A gas-forming fluid collection was discovered in the pelvic retroperitoneal fascia by computed tomography, but the patient did not show marked symptoms of sepsis. Emergency laparotomy drainage and debridement were performed. Clostridium difficile was isolated, and she was treated with a three-week course of vancomycin. The patient recovered without major morbidity. Recent case reports describe variation in the course of the disease and management options for puerperal retroperitoneal infection. Conclusion: Puerperal retroperitoneal abscess caused by C. difficile can present with minimal symptoms. Prompt recognition, early surgical intervention, and optimal use of antibiotics can reduce morbidity and prevent death.Surgical Infections 05/2014; DOI:10.1089/sur.2012.104 · 1.72 Impact Factor
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ABSTRACT: Piriformis pyomyositis is defined as a subacute infection of skeletal muscles associated with systemic infectious symptoms. In the literature it rarely occurs postpartum. We report a case of piriformis pyomyositis involving a parturient and review the published cases available in the literature.The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 11/2011; 25(8):1505-7. DOI:10.3109/14767058.2011.636098 · 1.21 Impact Factor
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ABSTRACT: We sought to determine the bidirectional transfer and distribution of vancomycin and telavancin across the dually perfused term human placental lobule. The technique of dually perfused placental lobule was used in its recirculating mode to determine the maternal to fetal (M→F) (n = 20) and fetal to maternal (n = 18) transfer of each antibiotic, which were coperfused with their radioactive isotopes. The concentrations of drugs were determined by liquid scintillation spectrometry. In the M→F direction, the transfer of vancomycin (9.6 ± 4%) and telavancin (6.5 ± 2%) were low; however, telavancin retention by the perfused lobule was greater than that of vancomycin (P < .01). The normalized transplacental transfer of telavancin across the placental lobule in the fetal to maternal direction was higher than in the M→F direction (P < .01), suggesting the involvement of placental efflux transporters. The ex vivo perfusion experiments revealed low transfer of vancomycin and telavancin to the fetal circuit.American journal of obstetrics and gynecology 08/2012; 207(4):331.e1-6. DOI:10.1016/j.ajog.2012.06.064 · 3.97 Impact Factor