Presentación atípica de piomiositis tropical difusa de psoas por Staphylococcus aureus meticilino resistente / Atypical presentation of diffuse tropical pyomiositis of the psoas due to methicillin resistant Staphylococcus aureus

La piomiositis tropical difusa primaria es una enfermedad de presentación infrecuente en nuestro medio, con pocos casos asociados a Staphylococcus aureus meticilino resistente, adquirido en la comunidad (MRSA-AC). Se presenta el caso de un paciente de 70 años, con tratamiento irregular para diabetes mellitus tipo 2, que fue hospitalizado por presentar un cuadro de diez días de evolución, con dolor lumbar irradiado a miembro inferior izquierdo, fiebre y flexión forzada de la cadera derecha por dolor a la movilización. El diagnóstico de piomiositis difusa de ambos psoas se realizó con resonancia magnética. Del cultivo de una colección paravertebral posterior se aisló Staphylococcus aureus resistente a oxacilina, penicilina y dicloxacilina.

Diffuse tropical primary pyomyositis is an infrequent entity in our country, with few cases associated to communityacquired Methicillin- resistant Staphylococcus aureus. There are no reported cases of Community-Acquired Methicillin- Resistant Staphylococcus aureus (CA- MRSA) in Peru. We present the case of a 70 year old male with a previous diagnosis of type 2 diabetes mellitus, receiving irregular treatment, who was admitted to the hospital with a history of 10 days of low back pain radiating to the left leg, fever and forced flexion of the right hip due to pain during movement. The diagnosis of diffuse pyomyositis of both psoas muscles was performed with MRI and culture of a posterior paravertebral collection, from which Staphylococcus aureus resistant to oxacillin, penicillin and dicloxacillin was isolated.

Angiomiolipoma renal / Kidney angiomiolipoma

We report a fifty threes years old female patient, who suffered right lumbar pain, total hematuria and palpable abdominal mass. An abdominal T.A.C. showed a right renal tumor of fat density. Renal Angiomiolipoma an teratoma were considered among neoformative processes. It wasn't found any tumor's extension. Radical nefrectomy was done. The histopatologic diagnosis was renal angiomiolipoma.