Korean J Thorac Cardiovasc Surg.  2015 Dec;48(6):443-446. 10.5090/kjtcs.2015.48.6.443.

Mycotic Abdominal Pseudoaneurysm due to Psoas Abscess after Spinal Fusion

• Ryu DW
• Lee SY
• Lee MK

• KMID: 2382308
• DOI: http://doi.org/10.5090/kjtcs.2015.48.6.443

Abstract

A 36-year-old man, who had undergone thoracoscopic anterior spinal fusion using the plate system and posterior screw fusion three months previously, presented to our hospital with left flank pain and fever. Computed tomography indicated the presence of a psoas muscle abscess. However, after two days of percutaneous catheter drainage, a mycotic abdominal aortic pseudoaneurysm was detected via computed tomography. We performed in situ revascularization using a prosthetic graft with omental wrapping. Methicillin-resistant Staphylococcus aureus was identified on blood and pus culture, and systemic vancomycin was administered for one month. Although the abscess recurred, it was successfully treated with percutaneous catheter drainage and systemic vancomycin administration for three months, without the need for instrumentation removal. The patient remained asymptomatic throughout two years of follow-up.

Keyword

Aneurysm, infected; Psoas abscess; Methicillin-resistant Staphylococcus aureus; Spinal fusion

MeSH Terms

Abscess
Adult
Aneurysm, False*
Aneurysm, Infected
Catheters
Drainage
Fever
Flank Pain
Follow-Up Studies
Humans
Methicillin-Resistant Staphylococcus aureus
Psoas Abscess*
Psoas Muscles
Spinal Fusion*
Suppuration
Transplants
Vancomycin
Vancomycin