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[Iliopsoas abscess accompanied by epidural abscess--a case report]
Tetsushi Fukushige1, Tomomi Sano, Sinichi Yamada
1Department of Anesthesiology, Kurume University School of Medicine, Kurume 830-0011.
Masui. the Japanese Journal of Anesthesiology
|October 9, 2003
Summary
Iliopsoas abscess can mimic lumbar disc herniation. Prompt diagnosis and treatment, including aspiration, are crucial for effective management of iliopsoas and epidural abscesses.
Area of Science:
- Infectious Diseases
- Neurosurgery
- Radiology
Background:
- Low back and leg pain with fever can indicate serious conditions.
- Lumbar disc herniation is a common initial suspicion for these symptoms.
Observation:
- A 55-year-old man presented with low back and left leg pain and fever.
- Initial assessment suggested lumbar disc herniation, but imaging revealed left iliopsoas muscle swelling.
- Magnetic resonance imaging (MRI) confirmed concurrent iliopsoas and epidural abscesses.
Findings:
- Initial antibiotic therapy for 8 days resolved fever but not pain.
- Persistent abscess on MRI 20 days post-antibiotics indicated incomplete resolution.
- Fluoroscopically guided epidural aspiration of 3 ml pus led to remarkable symptom relief.
Implications:
- Iliopsoas abscess should be considered in patients with low back/leg pain and inflammatory signs.
- Combined iliopsoas and epidural abscesses require prompt diagnosis and potentially interventional procedures.
- Early recognition and appropriate management are key to successful outcomes in complex abscess cases.