Version 1
: Received: 12 August 2024 / Approved: 12 August 2024 / Online: 12 August 2024 (14:00:20 CEST)
How to cite:
Ovidiu, M.; Sima, L.; Popa, D. I.; Williams, C. G.; Mitu, D.; Sutoi, D.; Trebuian, C. I.; Mircea, S.; Buleu, F. Primary Iliopsoas Abscess and Drug-Induced Acute Liver Failure in the Emergency Department: A Common Symptom, an Uncommon Diagnosis. Preprints2024, 2024080828. https://doi.org/10.20944/preprints202408.0828.v1
Ovidiu, M.; Sima, L.; Popa, D. I.; Williams, C. G.; Mitu, D.; Sutoi, D.; Trebuian, C. I.; Mircea, S.; Buleu, F. Primary Iliopsoas Abscess and Drug-Induced Acute Liver Failure in the Emergency Department: A Common Symptom, an Uncommon Diagnosis. Preprints 2024, 2024080828. https://doi.org/10.20944/preprints202408.0828.v1
Ovidiu, M.; Sima, L.; Popa, D. I.; Williams, C. G.; Mitu, D.; Sutoi, D.; Trebuian, C. I.; Mircea, S.; Buleu, F. Primary Iliopsoas Abscess and Drug-Induced Acute Liver Failure in the Emergency Department: A Common Symptom, an Uncommon Diagnosis. Preprints2024, 2024080828. https://doi.org/10.20944/preprints202408.0828.v1
APA Style
Ovidiu, M., Sima, L., Popa, D. I., Williams, C. G., Mitu, D., Sutoi, D., Trebuian, C. I., Mircea, S., & Buleu, F. (2024). Primary Iliopsoas Abscess and Drug-Induced Acute Liver Failure in the Emergency Department: A Common Symptom, an Uncommon Diagnosis. Preprints. https://doi.org/10.20944/preprints202408.0828.v1
Chicago/Turabian Style
Ovidiu, M., Selaru Mircea and Florina Buleu. 2024 "Primary Iliopsoas Abscess and Drug-Induced Acute Liver Failure in the Emergency Department: A Common Symptom, an Uncommon Diagnosis" Preprints. https://doi.org/10.20944/preprints202408.0828.v1
Abstract
Abstract:
Background and objective: Iliopsoas abscess (IPA) is a rare condition with varied symptomology and etiology. Less than one-third of patients with IPA present on the emergency department (ED) admission with the traditional triad of fever, back pain, and restricted hip motion (or limp), leading to delays in diagnosis and management. This case report aims to bring awareness among healthcare professionals regarding the atypical presentation and introduce a potential differential diagnosis when evaluating patients with fever and back pain. The intention is to provide insights into the signs and symptoms that may indicate the presence of an iliopsoas abscess and prompt additional investigations.
Case report: Here, we describe a case of primary iliopsoas abscess associated with drug-induced acute liver failure in our ED. The patient complained of pain in the left lumbar region and fatigue that started two weeks before this presentation, claiming that, during the previous night, the pain suddenly worsened. She had a fever, pain at palpation in the right hypochondriac and left lumbar regions, accompanied by fever and vomiting, jaundiced skin, and sclera at the examination in ED. On abdominal ultrasonography, the diagnosis of acute cholangitis was suspected. The laboratory test shows leukocytosis with neutrophilia, thrombocytosis, hepatocytolysis syndrome, and hyperbilirubinemia with the predominance of indirect bilirubin. We performed then abdominal and pelvic computed tomography, which confirmed the diagnosis of cholelithiasis observed with the diameter of the bile duct within normal limits but also showed an abscess-like collection fused to the interfibrillar level of the left iliopsoas muscle; a diagnosis we most likely would have been missed. After that, the patient was hospitalized in the General Surgery Department, and surgery drainage of the abscess was performed. The patient's evolution was excellent; she was discharged after 11 days.
Conclusions: The case presented here exemplifies how iliopsoas abscess, a rare cause of back pain, can quickly go unrecognized, especially in the emergency department. Our experiences will raise awareness among doctors in emergency departments about this uncommon but essential diagnosis. With advancements in diagnostic tools and techniques, we aspire that more cases of iliopsoas abscess will be accurately diagnosed.
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
