Oct 10, 2015 - Although it is unspecific, the triad of fever, lumbar/abdominal pain and limp was observed in 12(60%) pts; however, 2 of them alone or in ...
1531. Psoas Abscess in Children: A Forgotten Diagnosis Marina Elisa Pasinovich, MD; María Laura Praino, MD; Ximena S. Juárez, MD; Micaela Delgado, MD; Claudia I. Cazes, MD; Eduardo López, MD; Hospital de Niños Dr. Ricardo Gutiérez, Ciudad Autónoma de Buenos Aires, Argentina Session: 220. Clinical Infectious Diseases: Soft Tissue Infections (ABSSSSIs) Saturday, October 10, 2015: 12:30 PM Background. Psoas abscess (PA), mainly caused by Staphylococcus aureus is uncommon condition in children. The absence of specific signs and symptoms delays diagnosis. We decide to characterize PA clinical features in children in our setting. Methods. Cross sectional study in an argentinian tertiary care pediatric center. Hospitalized children with PA at discharge, from February 2013 to February 2015. Demographic, clinical, image data and laboratory results were analyzed. EPI Info 3.2.2 versus was used. Results. PA was diagnosed in 20 patients ( pts). The hospitalization rate was 10.5/ 10,000 (95% CI 6.4–16.3); female/male ratio 1.22:1. Age: 105.7 (±56.6), 16–203 ms; 50% of pts were admitted with a different diagnosis. PA was primary in 13 (65%). Days of evolution at diagnosis: 11.1 (±9.1) ds. Predisposing factors were found in 16 (80%): trauma, skin and soft tissue infect and myelomeningocele Although it is unspecific, the triad of fever, lumbar/abdominal pain and limp was
observed in 12(60%) pts; however, 2 of them alone or in combination with other feature were present in additional 5 (25%) pts. Abnormal acute phase reactants: Leucocyte: 19,005 (±8288)/mm3; ESR: 73. 4 (±30.2) mm/hr and CRP: 161.6 mg/dL (±92.5) were seen in most pts S. aureus was identified in 15 (75%) cases; MRSA 12 (80%); no other agent was identified. Only 3 pts had positive blood cultures. Diagnosis was confirmed by ultrasound: 13 (65%), TC scan: 5 (25%), MRI: 2(10%) Initial empirical therapy for S.aureus was applied in 100% pts on admission, CLI: 12 (60%), CLI + VAN: 3 (15%), other combinations: 5 (25%). Duration of IV therapy: 18.4 (±14) ds. Pts who required drainage were diagnosed latter than those who wereńt drained ( p = 0.03), median 11 versus 7, respectively. Drainage was performed in 13 (65%), although it was not associated to shorter hospital stay Complications: pneumonia, endocarditis and septic hip arthritis in 2 pts; in both of them the hospitalization was statistically longer: 49.5 (±40.3) versus 17.7 (±6.4), ( p < 0.001) Conclusion. (1) The number of PA in children described in this report is higher than the literature reports. (2) PA should be suspected in pts with fever, lumbar/ abdominal pain and limp. (3) Suspected PA should be explored by ultrasound at least at admission. (4) Pts who required drainage were diagnosed later in the evolution. (5) Complications of PA statistically prolongs the hospital stay. Disclosures. All authors: No reported disclosures.
Poster Abstracts
•
OFID 2015:2 (Suppl 1)
•
S379
