Appendicitis Presenting As Cellulitis of the Right Leg

Abstract Background Several infectious processes of intra-abdominal origin may atypically present as skin or soft tissue infections or abscess in the thigh. Case Report We describe the case of a 73-year-old woman who presented to the emergency department with the clinical picture of a skin infection...

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Bibliographic Details
Published in:The Journal of emergency medicine 2017-01, Vol.52 (1), p.e1-e3
Main Authors: van Hulsteijn, Leonie T., MD, PhD, Mieog, J. Sven D., MD, PhD, Zwartbol, Maarten H.T., MD, Merkus, Jos W.S., MD, PhD, van Nieuwkoop, Cees, MD, PhD
Format: Article
Language:English
Subjects:
abscess
Aged
Anti-Bacterial Agents - pharmacology
Anti-Bacterial Agents - therapeutic use
appendicitis
Appendicitis - complications
Appendicitis - diagnosis
Cefuroxime - pharmacology
Cefuroxime - therapeutic use
cellulitis
Cellulitis - diagnosis
Cellulitis - drug therapy
Emergency
Emergency Service, Hospital - organization & administration
Escherichia coli - pathogenicity
Female
Humans
imaging
Klebsiella pneumoniae - pathogenicity
Magnetic Resonance Imaging - methods
Metronidazole - pharmacology
Metronidazole - therapeutic use
Pyomyositis - diagnosis
Retroperitoneal Space - abnormalities
Retroperitoneal Space - microbiology
skin infection
soft tissue infection
Soft Tissue Infections - complications
Soft Tissue Infections - therapy
Thigh - abnormalities
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Summary:Abstract Background Several infectious processes of intra-abdominal origin may atypically present as skin or soft tissue infections or abscess in the thigh. Case Report We describe the case of a 73-year-old woman who presented to the emergency department with the clinical picture of a skin infection of the right leg. The patient's condition deteriorated during medical treatment with intravenous antibiotics. Subsequent radiologic imaging revealed that the complaints were caused by a bulging retroperitoneal appendicular abscess along the iliopsoas muscle, although the patient experienced no abdominal symptoms. The patient recovered completely after surgical intervention. Why Should An Emergency Physician Be Aware of This? Timely performance of anatomic imaging in patients with unexplained skin or soft tissue infections and thigh abscesses is important because these findings may be manifestations of an abdominal pathology. A correct diagnosis in the emergency department prohibits delays in treatment.
ISSN:0736-4679
2352-5029
DOI:10.1016/j.jemermed.2016.07.008