Multiple Retroperitoneal Abscesses Caused by Extended-Spectrum β-Lactamase-Producing Escherichia coli: A Case Report
Abstract
Diagnosis and management of retroperitoneal abscesses caused by ESBL (Extended-Spectrum-β-Lactamase) Escherichia Coli require special attention. A female patient came to the Emergency Department with complaints of abdominal discomfort, bloating, nausea, fever, and urination pain for 1 week, and physical examination demonstrated an enlarged mass in the left flank for the past 6 months. Laboratory results showed an increase in leukocytes and procalcitonin hence the antibiotic cefoperazone sulbactam was given as empirical therapy. An abdominal CT scan revealed multiple retroperitoneal abscesses in the left and right hemiabdomen, therefore levofloxacin and metronidazole were given as additional antibiotics. Percutaneous abscess drainage was performed and from the pus culture obtained grew ESBL Escherichia Coli bacteria. Furthermore, antibiotics were changed to intravenous amikacin according to the results of the susceptibility test. The patient's clinical symptoms improved significantly and she was discharged and evaluated in the outpatient clinic.
1. Huang SH, Lo WO, Lin CM, Hsieh TS, Wang SF, Tsai SW, et al. Retroperitoneal abscess: 7-year experience of 29 cases in a tertiary care center in Taiwan. Urol Sci. 2015;26(3).
2. Patel BC, Wayangankar SA, Ngo E, Chakrabarty S, Bronze MS. Primary retroperitoneal abscess caused by Candida glabrata. Am J Med Sci [Internet]. 2012;344(4):332–4.
3. Shaikh S, Fatima J, Shakil S, Rizvi SMD, Kamal MA. Antibiotic resistance and extended spectrum beta-lactamases: Types, epidemiology and treatment. Saudi J Biol Sci. 2015;22(1).
4. Li Z, Tang Y, Wang P, Ren J. Diagnosis and Treatment of Retroperitoneal Infection. Surg Infect (Larchmt). 2021;22(5):477–84.
5. Coffin A, Boulay-Coletta I, Sebbag-Sfez D, Zins M. Radioanatomy of the retroperitoneal space. Vol. 96, Diagnostic and Interventional Imaging. 2015.
6. Winter BM, Gajda M, Grimm M-O. Diagnostik und Therapie retroperitonealer Abszesse. Urologe [Internet]. 2016 Jun 25;55(6):741–7.
7. Ioannidis O, Kakoutis E, Katsifa H, Rafail S, Chatzopoulos S, Kotronis A, et al. Streptococcus mutans: A rare cause of retroperitoneal abscess. Adv Med Sci. 2011;56(1).
8.Crepps JT, Welch JP, Orlando R. Management and outcome of retroperitoneal abscesses. Ann Surg. 1987;205(3).
9.Mallia AJ, Ashwood N, Arealis G, Galanopoulos I. Retroperitoneal abscess: An extra-abdominal manifestation. BMJ Case Rep. 2015;2015.
10. Alam F, Salam A, Mahmood I, Kabir M, Chowdhury S, Haque R. Amebic Liver Abscess is Associated with Malnutrition and Low Serum Leptin Level. J Infect Dis Ther. 2016;4(5).
11. De Montmollin E, Corcos O, Noussair L, Leflon-Guibout V, Belmatoug N, Joly F, et al. Retroperitoneal abscesses due to Nocardia farcinica: Report of two cases in patients with malnutrition. Vol. 40, Infection. 2012. p. 93–6.
12. Briongos-Figuero LS, Gõmez-Traveso T, Bachiller-Luque P, Domínguez-Gil González M, Gõmez-Nieto A, Palacios-Martín T, et al. Epidemiology, risk factors and comorbidity for urinary tract infections caused by extended-spectrum beta-lactamase (ESBL)-producing enterobacteria. Int J Clin Pract. 2012;66(9).
13. Aboumarzouk OM. Extended spectrum beta-lactamase urinary tract infections. Urol Ann [Internet]. 2014;6(2):114–5. Available from: www.urologyannals.com
14. Zaoutis TE, Goyal M, Chu JH, Coffin SE, Bell LM, Nachamkin I, et al. Risk factors for and outcomes of bloodstream infection caused by extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella species in children. Pediatrics. 2005;115(4):942–9.
15.Kitaoka H, Inatomi J, Chikai H, Watanabe K, Kumagai T, Masui A, et al. Renal abscess with bacteremia caused by extended-spectrum β-lactamase-producing Escherichia coli: A case report. BMC Pediatr. 2020;20(1):1–5.
16. Amin O, Prestel C, Gonzalez MD, Lyon T, Shane A, Jaggi P, et al. Urinary Tract Infections with Extended-spectrum-β-lactamase-producing Bacteria: Case-control Study. Pediatr Infect Dis J. 2020;39(3).
17. Kantamalee W, Santanirand P, Saisawat P, Boonsathorn S, Techasaensiri C, Apiwattanakul N. Outcomes of Empirical Antimicrobial Therapy for Pediatric Community-onset Febrile Urinary Tract Infection in the Era of Increasing Antimicrobial Resistance. Pediatr Infect Dis J. 2020;39(2).
18.Tratselas A, Iosifidis E, Ioannidou M, Saoulidis S, Kollios K, Antachopoulos C, et al. Outcome of Urinary Tract Infections Caused by Extended Spectrum β-Lactamase-producing Enterobacteriaceae in Children. Pediatr Infect Dis J. 2011;30(8).
19. Calbo E, Romaní V, Xercavins M, Gómez L, Vidal CG, Quintana S, et al. Risk factors for community-onset urinary tract infections due to Escherichia coli harbouring extended-spectrum β-lactamases. J Antimicrob Chemother. 2006;57(4).
2. Patel BC, Wayangankar SA, Ngo E, Chakrabarty S, Bronze MS. Primary retroperitoneal abscess caused by Candida glabrata. Am J Med Sci [Internet]. 2012;344(4):332–4.
3. Shaikh S, Fatima J, Shakil S, Rizvi SMD, Kamal MA. Antibiotic resistance and extended spectrum beta-lactamases: Types, epidemiology and treatment. Saudi J Biol Sci. 2015;22(1).
4. Li Z, Tang Y, Wang P, Ren J. Diagnosis and Treatment of Retroperitoneal Infection. Surg Infect (Larchmt). 2021;22(5):477–84.
5. Coffin A, Boulay-Coletta I, Sebbag-Sfez D, Zins M. Radioanatomy of the retroperitoneal space. Vol. 96, Diagnostic and Interventional Imaging. 2015.
6. Winter BM, Gajda M, Grimm M-O. Diagnostik und Therapie retroperitonealer Abszesse. Urologe [Internet]. 2016 Jun 25;55(6):741–7.
7. Ioannidis O, Kakoutis E, Katsifa H, Rafail S, Chatzopoulos S, Kotronis A, et al. Streptococcus mutans: A rare cause of retroperitoneal abscess. Adv Med Sci. 2011;56(1).
8.Crepps JT, Welch JP, Orlando R. Management and outcome of retroperitoneal abscesses. Ann Surg. 1987;205(3).
9.Mallia AJ, Ashwood N, Arealis G, Galanopoulos I. Retroperitoneal abscess: An extra-abdominal manifestation. BMJ Case Rep. 2015;2015.
10. Alam F, Salam A, Mahmood I, Kabir M, Chowdhury S, Haque R. Amebic Liver Abscess is Associated with Malnutrition and Low Serum Leptin Level. J Infect Dis Ther. 2016;4(5).
11. De Montmollin E, Corcos O, Noussair L, Leflon-Guibout V, Belmatoug N, Joly F, et al. Retroperitoneal abscesses due to Nocardia farcinica: Report of two cases in patients with malnutrition. Vol. 40, Infection. 2012. p. 93–6.
12. Briongos-Figuero LS, Gõmez-Traveso T, Bachiller-Luque P, Domínguez-Gil González M, Gõmez-Nieto A, Palacios-Martín T, et al. Epidemiology, risk factors and comorbidity for urinary tract infections caused by extended-spectrum beta-lactamase (ESBL)-producing enterobacteria. Int J Clin Pract. 2012;66(9).
13. Aboumarzouk OM. Extended spectrum beta-lactamase urinary tract infections. Urol Ann [Internet]. 2014;6(2):114–5. Available from: www.urologyannals.com
14. Zaoutis TE, Goyal M, Chu JH, Coffin SE, Bell LM, Nachamkin I, et al. Risk factors for and outcomes of bloodstream infection caused by extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella species in children. Pediatrics. 2005;115(4):942–9.
15.Kitaoka H, Inatomi J, Chikai H, Watanabe K, Kumagai T, Masui A, et al. Renal abscess with bacteremia caused by extended-spectrum β-lactamase-producing Escherichia coli: A case report. BMC Pediatr. 2020;20(1):1–5.
16. Amin O, Prestel C, Gonzalez MD, Lyon T, Shane A, Jaggi P, et al. Urinary Tract Infections with Extended-spectrum-β-lactamase-producing Bacteria: Case-control Study. Pediatr Infect Dis J. 2020;39(3).
17. Kantamalee W, Santanirand P, Saisawat P, Boonsathorn S, Techasaensiri C, Apiwattanakul N. Outcomes of Empirical Antimicrobial Therapy for Pediatric Community-onset Febrile Urinary Tract Infection in the Era of Increasing Antimicrobial Resistance. Pediatr Infect Dis J. 2020;39(2).
18.Tratselas A, Iosifidis E, Ioannidou M, Saoulidis S, Kollios K, Antachopoulos C, et al. Outcome of Urinary Tract Infections Caused by Extended Spectrum β-Lactamase-producing Enterobacteriaceae in Children. Pediatr Infect Dis J. 2011;30(8).
19. Calbo E, Romaní V, Xercavins M, Gómez L, Vidal CG, Quintana S, et al. Risk factors for community-onset urinary tract infections due to Escherichia coli harbouring extended-spectrum β-lactamases. J Antimicrob Chemother. 2006;57(4).
| Files | ||
| Issue | Vol 60 No 9 (2022) | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/acta.v60i9.11103 | |
| Keywords | ||
| Retroperitoneal abscess Renal abscess Extended-spectrum β-lactamase Escherichia coli Case report | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Teressa M, Purnama Y, Lardo S. Multiple Retroperitoneal Abscesses Caused by Extended-Spectrum β-Lactamase-Producing Escherichia coli: A Case Report. Acta Med Iran. 2022;60(9):604-607.
