[Tuberculous psoas abscess in a patient with HIV]

Area of Science:

• Infectious Diseases
• Radiology
• Gastroenterology

Background:

• Psoas abscess is an uncommon condition with diverse causes.
• Staphylococcus aureus is the most frequent pathogen in primary abscesses.
• Crohn's disease is the leading cause of secondary psoas abscess.

Observation:

• Recent trends highlight drug abuse and HIV infection as significant risk factors.
• Mycobacterium tuberculosis is a rare but reported cause in HIV-positive individuals.
• Clinical presentation is often subtle, characterized by insidious onset of pain and fever.

Findings:

• Computed tomography (CT) is the cornerstone diagnostic modality.
• Percutaneous drainage under CT guidance is the primary treatment strategy.
• Open surgical drainage is reserved for refractory cases or specific abscess types.

Implications:

• Early diagnosis and appropriate management are crucial for patient outcomes.
• Understanding evolving risk factors like HIV and drug abuse is essential for clinical awareness.
• Tailoring surgical approaches (extraperitoneal vs. transperitoneal) based on abscess etiology improves treatment efficacy.