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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
Summary
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.
- 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.