Iliopsoas muscle abscess secondary to sacral pressure ulcer treated with computed tomography-guided aspiration and...

Iliopsoas abscess is an aggressive infection usually associated with Crohn's disease, spinal tuberculosis, a septic hip joint (including hip replacement), and spinal cord injury. It rarely occurs secondary to sacral pressure ulcer. The infection requires immediate surgical debridement or drainage. The case of a 78-year-old woman with high fever and severe inflammation caused by iliopsoas abscess secondary to a sacral pressure ulcer is reported. The patient was treated with a computed tomography-guided aspiration; Escherichia coli was isolated from the pus of the ulcer and abscess sites. The abscess completely resolved within 2 weeks but another abscess developed. Following surgery and daily cleansing, the drainage tube was removed after 1 week. Once granulation tissue formation was sufficient, the sacral wound was covered with gluteal fasciocutaneous rotation flaps 6 weeks after admission. The wounds closed and the patient made a full recovery within 2 months. Early recognition followed by immediate drainage of pus and appropriate antibiotic therapy are essential to the treatment of these wounds. Experience confirms that computed tomography-guided aspiration is useful and may be less damaging than surgical debridement.