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Psoas Abscesses Caused by Paracoccidioides brasiliensis in an Adolescent

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Abstract

Objective

In order to describe the case of an adolescent who developed psoas abscesses caused by Paracoccidiodes brasiliensis.

Description

A 12-year-old boy was admitted with a history of daily fever and global lymph nodes enlargement. He had been treated in the last 6 years, with irregular use of the drugs, for an acute form of paracoccidioidomycosis (PCM). He presented a tenderness fluctuating polyadenopathy in all cervical, submandibular, supraclavicular, axillary, and inguinal chains; several lymph nodes were up to 4 cm in diameter, hardened and coalescent. After 1 month of unsuccessful therapy with SMX-TMP, the patient presented a pain in the right groin and difficulty to walk. CT scan showed a global retroperitoneal lymph nodes enlargement, some with central necrosis and two bigger collections adjacent to both psoas muscles. A surgical drainage of the collections was performed for several times. The patient received a total of 1.9 g of Amphotericin B. After 1 month of the last surgical procedure, CT scan showed only a residual collection, and the patient was sent to ambulatory follow-up. We hypothesed that the retroperitoneal lymph nodes became a coalescent mass that fistulized to the psoas compartment.

Comments

The patient presented a febrile lymphoproliferative syndrome that is frequently seen in children with PCM. Although a polymorphic manifestation is observed in this disease, psoas abscess is a rare complication of PCM. The health professionals that take care of the patients with PCM must pay attention to the possibility of this one more complication.

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Authors and Affiliations

  1. Department of Pediatrics, Faculty of Medical Science, University of Campinas, Campinas, Brazil

    Mariana Tresoldi Neves, Antonia Teresinha Tresoldi & Ricardo Mendes Pereira

  2. Department of Orthopedics, Faculty of Medical Science, University of Campinas, Campinas, Brazil

    Bruno Livani & William Dias Belangero

Authors
  1. Mariana Tresoldi Neves
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  2. Bruno Livani
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  3. William Dias Belangero
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  4. Antonia Teresinha Tresoldi
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  5. Ricardo Mendes Pereira
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Corresponding author

Correspondence to Ricardo Mendes Pereira.

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Neves, M.T., Livani, B., Belangero, W.D. et al. Psoas Abscesses Caused by Paracoccidioides brasiliensis in an Adolescent. Mycopathologia 167, 89–93 (2009). https://doi.org/10.1007/s11046-008-9152-x

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  • DOI: https://doi.org/10.1007/s11046-008-9152-x

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