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[Tubercular psoas abscess].

S Buchholz1, D Marti, G Schulthess

  • 1Medizinische Klinik, Universitätsspitals Zürich, Schweiz.

Deutsche Medizinische Wochenschrift (1946)
|August 16, 2000
PubMed
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Extrapulmonary tuberculosis can manifest as a psoas muscle abscess, presenting with symptoms like fatigue and weight loss. Prompt antituberculosis treatment is effective, often avoiding surgery for this serious condition.

Area of Science:

  • Infectious Diseases
  • Radiology
  • Urology

Background:

  • Extrapulmonary tuberculosis (TB) is increasingly recognized, particularly in immigrant populations from high-incidence regions.
  • Differential diagnosis for abdominal masses should consider TB, especially with risk factors like recent immigration.
  • Psoas muscle abscesses can present with non-specific symptoms, mimicking other conditions.

Observation:

  • A 43-year-old male presented with fatigue, night sweats, rigor, and significant weight loss.
  • Imaging revealed an extensive right psoas muscle abscess causing ureteric displacement and hydronephrosis.
  • Abscess aspirate confirmed tuberculosis (TB).

Findings:

  • Antituberculosis treatment led to significant abscess shrinkage within 2 months.

Related Experiment Videos

  • A ureteric catheter was successfully removed after hydronephrosis resolved.
  • The patient's condition improved with conservative management, avoiding surgical intervention.

    • Implications:

    • This case highlights the importance of considering extrapulmonary TB in the differential diagnosis of psoas abscesses.
    • Effective antituberculosis chemotherapy can resolve large psoas abscesses, often negating the need for surgery.
    • Increased global migration necessitates heightened awareness of TB in non-traditional presentations.