Central   JSM Microbiology Cite this article: Aygun D, Bektas S, Kuruğoğlu S, Cokugras H, Camcioglu Y (2016) Iliopsoas Abscess with Septic Arthritis of the Hip Following Trauma in Two Adolescents. JSM Microbiology 4(2): 1033. *Corresponding author De niz Ayg un, Ista nb ul Unive rsity, De p a rtme nt o f Pe d ia tric Infe c tio us Dise a se s, C linic a l Immuno lo g y a nd Alle rg y, Ista nb ul, Turke y, Te l: 90-532-786-8682; Fa x: 90- 212-632-8633; Email: Submitte d: 27 O c to b e r 2016 Accepted: 29 No ve mb e r 2016 Publishe d: 01 De c e mb e r 2016 Copyright © 2016 Ayg un e t a l. OPEN ACCESS Ke ywo rds • Ilio pso a s a b sc e sse s • Tra uma • Ad o le sc e nt Case Series Iliopsoas Abscess with Septic Arthritis of the Hip Following Trauma in Two Adolescents Deniz Aygun 1 *, Sule Bektas 2 , Sebuh Kuruğoğlu 3 , Haluk Cokugras 1 , and Yildiz Camcioglu 1 1 Department of Pediatric Infectious Diseases, Clinical Immunology and Allergy, Istanbul University, Turkey 2 Department of Pediatrics, Istanbul University, Turkey 3 Department of Radiology, Istanbul University, Turkey Abstract Iliopsoas abscess is a relatively uncommon but potentially life-threatening infection of extraperitoneal compartment. Iliopsoas abscess is classifed as either primary or secondary. Primary abscess results from hematogenous spread of an infectious process from an occult source in the body. Trauma resulting intramuscular hematoma formation can predispose to primary Iliopsoas abscess formation. Iliopsoas abscess should be considered in patients presenting with lower back or hip pain and fever associated with trauma. Here, we describe two adolescent cases with iliopsoas abscess complicated by septic arthritis following trauma. ABBREVIATIONS ESR: Erythrocyte Sedimentation Rate; CRP: C-Reactive Protein; IPA: Iliopsoas Abscesses; MRI: Magnetic Resonance Imaging INTRODUCTION Iliopsoas abscesses (IPA) are suppurative collections within the fascia surrounding the psoas and iliacus muscles. Although the incidence of iliopsoas abscesses seems to increase in recent years due to improvements in diagnostic imaging, the new studies still regard it as a rare disease. IPA is a serious condition with a high mortality rate if left untreated [1]. Unfortunately, it is often misdiagnosed because of nonspecific symptoms. The classic signs of the disease including fever, flank or back pain, lumbar tenderness, limitation of hip movement and limping are present in only 30 % of patients [1]. Iliopsoas abscess was firstly reported by Mynter in 1881 as a complication of tuberculosis of spine and iliopsoas muscle [2]. At the present time, Staphylococcus aureus is the most common bacterial cause of iliopsoas abscess [3]. Trauma resulting with intramuscular hematoma formation can predispose to iliopsoas abscess formation. Here, we report two adolescent cases diagnosed with iliopsoas abscess complicated by septic arthritis of hip following trauma. Methicillin sensitive Staphylococcus aureus was isolated from the abscess samples of both patients. CASE PRESENTATION Case 1 A 17 year-old obese boy presented with complains of fever, malaise and left-side hip pain lasting for 1 week. He was unable to walk due to severe pain in his hip. On physical examination, he was febrile, he had redness, swelling, and increased warmth on the left gluteal region. Blood examination revealed leukocytosis (29600/mm 3 ) with 90% neutrophils, Erythrocyte sedimentation rate (ESR) level of 116 mm/hour, C-reactive protein (CRP) level of 387 mg/L. Magnetic resonance imaging (MRI) demonstrated a septated and multiloculated mass at the left iliopsoas muscle extending to left gluteal region indicating, hematoma, iliopsoas abscess and effusion of the hip joint with septic arthritis of the left hip (Figure 1). Case 2 The second patient, a 16 year-old male, was referred with a ten day history of left hip pain and fever. On physical examination only pain was noted in the hip joint on extension. Laboratory studies showed leukocytosis (10,900/mm 3 ) with 76% neutrophils, CRP level of 68 mg/L, and ESR of 127 mm/h. MRI revealed hematoma, abscess in the left psoas muscle and septic arthritis of the left hip joint (Figure 2). In both the cases; they were previously healthy. They had