A diagnostic masquerade: MRSA-induced iliopsoas abscess mimicking lower motor neuron disease

Iliopsoas pyogenic abscess is a rare clinical condition with non-specific symptoms that often delay diagnosis, leading to severe complications such as sepsis. The abscess may be primary, due to hematogenous spread, or secondary to adjacent infections, with Staphylococcus aureus being the most common causative agent. We report a rare case of bronchopneumonia and CA-MRSA-induced iliopsoas abscess in an immunocompetent patient where the initial presentation was dominated by lower limb weakness mimicking a neurological lesion, which delayed the discovery of the retroperitoneal abscess. Prompt multidisciplinary management enabled accurate diagnosis and successful treatment, resulting in the patient's full recovery and discharge.