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Posterior Approach for Debridement of the Psoas Abscess
Published on: March 2, 2020
Paradoxical Tuberculosis Immune Reconstitution Inflammatory Syndrome Complicated by Large Bilateral Psoas Abscess: A
Adriam M Castilla-Encinas1, Valeria Rocio Soto Salas2, Hugo Alvarez-Delgado1
1Sociedad Científica de San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Peru.
Abstract:
Immune reconstitution inflammatory syndrome is a common manifestation in human immunodeficiency virus (HIV)-positive patients infected with tuberculosis (TB). One of the unusual complications of this condition is the development of psoas abscess. We describe a case of immune reconstitution inflammatory syndrome (IRIS) in a patient with disseminated TB under treatment, HIV-positive with a low CD4 cell count, complicated by bilateral psoas abscess. Our patient presented with fever, abdominal pain, and lymphadenopathy, typical symptoms of TB-IRIS. Diagnosis was confirmed by surgical drainage of the abscess of the right iliac psoas muscle with detection of acid-fast bacteria on Ziehl-Neelsen staining and negative culture of purulent discharge. Treatment with prednisone was started in addition to continuation of antituberculosis therapy and antiretroviral therapy.
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