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Updated: Jul 9, 2025
Posterior Approach for Debridement of the Psoas Abscess
Published on: March 2, 2020
Psoas Abscess and Pott's Disease Masked by Concomitant Invasive Staphylococcus aureus Disease: A Case of Misleading
Patricia Bernardo1, Rita Gonçalves Pereira2, Carla Nobre3
1General Surgery, Centro Hospitalar Barreiro-Montijo, Barreiro, PRT.
Abstract:
Psoas abscess is a rare infection classified as primary or secondary depending on the etiology of infection. Staphylococcus aureus is considered the most frequent causative agent. Nevertheless, psoas abscess persistent lack of improvement or any relapse after successful treatment should remind us to exclude other potential diagnoses. Although less frequently, Pott's disease is still one of the predisposing causes, especially in patients with immunocompromised status. This clinical condition has an indolent course and requires a high index of suspicion to avoid severe morbidity. Early recognition and targeted treatment are the principal means of ensuring tuberculosis control. Here we report a very interesting case of a psoas abscess and Pott's disease in a patient suffering from a misleading diagnosis of invasive staphylococcal disease.
Insights
Psoas abscess can be caused by Pott's disease, a form of tuberculosis, not just Staphylococcus aureus. Early diagnosis of Pott's disease is crucial for effective tuberculosis control.
Area of Science:
- Infectious Diseases
- Radiology
- Orthopedics
Background:
- Psoas abscess is a rare infection, often attributed to Staphylococcus aureus.
- Secondary causes require consideration, especially in cases of treatment failure or relapse.
Observation:
- A patient presented with a psoas abscess initially misdiagnosed as invasive staphylococcal disease.
- The patient had an indolent course, necessitating a high index of suspicion for alternative diagnoses.
Findings:
- Pott's disease (tuberculosis of the spine) was identified as the underlying cause of the psoas abscess.
- This highlights the importance of considering tuberculosis in persistent or recurrent psoas abscesses, particularly in immunocompromised individuals.
Implications:
- Early recognition and targeted treatment of Pott's disease are vital for controlling tuberculosis spread.
- This case underscores the need for comprehensive diagnostic evaluation beyond common pathogens in complex infections.
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