technetium-tc-99m-exametazime and Gram-Positive-Bacterial-Infections

Psoas abscess associated with hip arthroplasty infection is a rare entity. The aim of this report was to review our experience.. Patients with computerized tomography (CT) diagnosis of psoas abscess associated with a hip arthroplasty infection from 2004 to 2009 were retrospectively reviewed. Demographics, microbiological data, CT results and outcome of each patient were recorded.. Seven patients out of 214 evaluated by CT due to hip infection suspected were identified. Three women and 4 men, with a mean age of 69 years (range 46-89). Mean abscess diameter was of 62 x 47 mm. In all cases, a direct communication between abscess and prosthesis was observed. The most commonly isolated microorganisms were grampositive cocci. All patients were treated with two-stage revision surgery. After a mean follow-up of 65 months (28-113), six patients were in remission.. The use of CT in the study of suspected infection of a hip arthroplasty identified a psoas abscess in 7 cases out of 214 evaluated. Patients treated with two-stage revision surgery and large debridement was associated with a good clinical outcome.

Topics: Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip; Disease Progression; Female; Follow-Up Studies; Gram-Positive Bacterial Infections; Gram-Positive Cocci; Humans; Male; Middle Aged; Polymerase Chain Reaction; Positron-Emission Tomography; Postoperative Complications; Prosthesis-Related Infections; Psoas Abscess; Radiopharmaceuticals; Reoperation; Technetium Tc 99m Exametazime

Two abscesses were shown on CT in a 72-year-old man: one in the left hip and one in the left pelvic region that resulted from a motor vehicle collision that occurred 8 months earlier. Bone scintigraphy showed increased uptake in the left hip area. On Tc-99m HMPAO leukocyte imaging, the hip area appeared to be photopenic, and the abscess of the left pelvis was not identified. Incidental uptake in the left lung base appeared to be an active acute inflammatory process as evidenced by an infiltrating lesion in the left lower lung on a chest radiograph. Because leukocyte scintigraphy cannot detect the presence of a chronic inflammatory process in the absence of acute inflammatory cells, the patient's abscesses in the left hip and the left pelvis did not localize Tc-99m HMPAO-labeled neutrophils. The cold lesion in the left hip area was most likely caused by the lesion in the reticuloendothelial system (bone marrow); the unidentifiable pelvic lesion was related to the area(s) outside the reticuloendothelial system. In interpreting a labeled leukocyte image, clinicians should be alert to the stage (chronic or acute) and location (regardless of whether in the reticuloendothelial system) of infectious lesion(s). In this patient, a wide spectrum of manifestations was evident on leukocyte scintigraphy.

Topics: Abscess; Aged; Enterococcus faecalis; Gram-Positive Bacterial Infections; Hip; Humans; Inflammation; Leukocytes; Lung Diseases; Male; Neutrophils; Pelvis; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Exametazime; Tomography, X-Ray Computed

Topics: Cerebrospinal Fluid Shunts; Child; Enterococcus faecalis; Gram-Positive Bacterial Infections; Humans; Leukocytes; Male; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Exametazime; Time Factors