Psoas primary abscess: A case report in an immunocompetent subject

Area of Science:

• Infectious Diseases
• Radiology
• Surgical Pathology

Background:

• Primary psoas abscess is a rare infectious disease with undefined incidence and etiopathogenesis.
• It is typically seen in immunocompromised individuals, often in developing countries.
• The involvement of immunocompetent subjects is exceptionally rare.

Observation:

• A 67-year-old immunocompetent patient presented with severe abdominal pain and an infectious syndrome.
• Clinical examination revealed a painful abdominal mass; CT scan confirmed a heterogeneous fluid collection in the psoas muscle.
• No specific microorganisms were isolated from the abscess fluid.

Findings:

• Computed Tomography (CT) scan is highly sensitive for diagnosing psoas abscess.
• Diagnosis can be challenging due to non-specific clinical signs.
• Staphylococcus aureus is the most common causative agent, though not isolated in this case.

Implications:

• This case highlights the possibility of primary psoas abscess in immunocompetent patients.
• Prompt diagnosis and combined medical-surgical treatment, including drainage and antibiotics, are essential.
• Early intervention is critical for managing this potentially serious condition.