下背痛：須戒慎的陷阱－腰肌膿性肌炎：一病例報告

腰肌膿性肌炎(psoas muscle pyomyositis)是指腰肌的化膿性炎症，常見於熱帶地區，多爲金黃色葡萄球菌感染所致。台灣位處亞熱帶，理論上腰肌膿性肌炎的個案應不少，但仍少見於國內報告，較難診斷可能是原因之一。在此，我們報告一例腰肌膿性肌炎的病例；以再次提醒臨床醫師，如果發現下背痛合併發燒的病例，一定要將腰肌膿性肌炎列爲可能的鑑別診斷。病人是50歲的婦女，主訴右下背痛兩星期，體重減輕，食慾減低等。身體檢查有發燒及psoas sign呈陽性。作CT後，診斷爲腰肌膿性肌炎（蜂窠組織炎歎，phlegmon）。經內科療法（針劑及口服抗生素）治療後，病人的症狀改善，血液常規，CRP及CT也趨正常。若腰肌膿性肌炎能在早期就被診斷出來，將對病人的治療及預後有很大的助益。

關鍵字

腰肌膿性肌炎；腰肌徵候；蜂窠組織炎

並列摘要

Psoas muscle pyomyositis, which refers to suppurative inflammation of skeletal muscle (psoas), is an infectious disease mostly caused by Staphylococcus aureus. It is most frequently reported in tropical and subtropical and extremely rare case in Taiwan, therefore it might result from difficulty in diagnosis. Herein, we report a case of psoas muscle pyomyositis that clinically presented as low back pain associated with fever. A 50-yearold female patient complained of right lower back pain for two weeks, weight loss, and poor appetite. Physical examination noted fever and positive psoas sign. She was diagnosed to have psoas muscle pyomyositis (the phlegmon stage) by CT-scan. She was treated conservatively by antibiotics, her symptoms and signs got improved. Blood routine, CRP as well as follow-up CT scan revealed normal. Therefore we conclude that early diagnosis of psoas muscle pyomyositis will benefit greatly by proper antibiotics treatment and with excellent prognosis.

並列關鍵字

Psoas pyomyositis ； Psoas sign ； Phlegmon

國際替代計量

下背痛：須戒慎的陷阱－腰肌膿性肌炎：一病例報告

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