Bilateral psoas abscess in the emergency department

Area of Science:

• Medical Case Reports
• Infectious Diseases
• Musculoskeletal Conditions

Background:

• Psoas abscess is an uncommon but serious condition often presenting with vague symptoms.
• Acute low back pain is frequently attributed to benign causes, delaying diagnosis of underlying serious pathology.
• High morbidity and mortality rates are associated with psoas abscess if not promptly identified.

Purpose of the Study:

• To present a case of bilateral psoas abscess mimicking mechanical low back pain.
• To emphasize the diagnostic challenges posed by atypical presentations of psoas abscess.
• To underscore the importance of physician vigilance in evaluating acute low back pain.

Main Methods:

• Case presentation of a 45-year-old female with recurrent emergency department visits for acute low back pain.
• Clinical history and physical examination findings leading to the diagnosis of bilateral psoas abscess.
• Diagnostic workup initiated due to suspicion of a serious spinal condition.

Main Results:

• The patient was diagnosed with bilateral psoas muscle abscess after multiple presentations.
• The presentation mimicked common mechanical low back pain, despite the serious underlying etiology.
• The patient had few known risk factors for developing a psoas abscess.

Conclusions:

• Bilateral psoas abscess can present insidiously and mimic benign low back pain.
• Physician vigilance and thorough workup are essential for diagnosing uncommon causes of acute low back pain.
• Prompt diagnosis and management are critical to reduce morbidity and mortality associated with psoas abscess.