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Published on: July 18, 2017
Psoas abscess caused by Escherichia coli pyelonephritis, A Case Report
L Tack1,2, M Ketels2, M Vanrenterghem3
1Ghent University Hospital, Department of Physical Therapy and Rehabilitation, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
Abstract:
An iliopsoas abscess is a rare accumulation of pus in the iliopsoas muscle compartment and can be divided into primary and secondary abscesses. Considering the rarity and nonspecific symptomatology, as well as the generally insidious subacute onset, a delay in diagnosis and treatment frequently occurs. We present a case of a 74-year-old woman with a psoas abscess due to an E. coli pyelonephritis. Psoas abscesses resulting from genitourinary tract infections are infrequently described in literature. The aim of this case report is to raise awareness of the nonspecific presentation and the importance of a thorough history and clinical examination to reduce delay in diagnosis. Clinicians should also keep in mind that a psoas abscess is often diagnosed prior to detection of the primary disease and should be attentive for these primary lesions. A follow-up of at least 1 year is recommended due to the reported relapse in 15% to 36% of the cases up to one year after initial presentation.
Insights
Iliopsoas abscesses are rare infections often diagnosed late due to vague symptoms. Early recognition and thorough examination are crucial for timely treatment and preventing complications.
Area of Science:
- Medicine
- Infectious Diseases
- Radiology
Background:
- Iliopsoas abscesses, pus collections in the iliopsoas muscle, are uncommon and present with nonspecific symptoms.
- Diagnosis is often delayed due to the insidious onset and subtle clinical signs.
Observation:
- A case report details a 74-year-old woman with an iliopsoas abscess secondary to E. coli pyelonephritis.
- Psoas abscesses originating from genitourinary infections are rarely documented.
Findings:
- Nonspecific presentations necessitate a high index of suspicion and meticulous clinical evaluation.
- Psoas abscesses may be diagnosed before the primary infection, such as pyelonephritis, is identified.
Implications:
- Increased awareness of nonspecific symptoms can reduce diagnostic delays for iliopsoas abscesses.
- A prolonged follow-up (at least 1 year) is recommended due to a significant relapse rate (15-36%).
Related Concept Videos
Urinary Tract Infection I: Introduction
Urinary Tract Infection II: Pathophysiology
Acute Pyelonephritis I: Introduction
Acute Pyelonephritis II: Diagnostic Studies and Management
Bacterial Gastroenteritis
Brain Abscess l: Introduction

