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Primary psoas abscess. Report of three cases
J Melissas1, J Romanos, E de Bree
1Department of Surgical Oncology, Heraklion, University Hospital, Greece. melissas@med.uoc.gr
Acta Chirurgica Belgica
|June 8, 2002
Summary
Primary psoas abscesses present with non-specific symptoms, making early diagnosis difficult. Prompt CT scans, surgical drainage, and antibiotics are crucial for successful treatment of these rare infections.
Area of Science:
- Infectious Diseases
- Surgical Pathology
Background:
- Primary psoas abscesses are uncommon infections with subtle, non-specific symptoms.
- Physicians face challenges in the early diagnosis and management of these rare conditions.
Observation:
- Three patients with primary pyogenic psoas abscess presented with fever, abdominal pain, and a tender mass.
- Limping was absent in all cases, and positive psoas signs were present in only two.
- Computed tomography (CT) accurately diagnosed the abscess in all three patients.
Findings:
- Successful treatment involved antibiotics and prolonged surgical drainage.
- Causative bacteria included Staphylococcus aureus and, notably, Bacteroides fragilis in one case.
- None of the patients had identifiable predisposing risk factors for infection.
Implications:
- A high index of suspicion is essential for early recognition of primary psoas abscess.
- CT scanning is the definitive diagnostic modality.
- Effective treatment relies on prolonged drainage and targeted antibiotic therapy.