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Psoas abscess with sepsis mimicking traumatic hemorrhagic shock after a fall
S Luber1, W J Brady, J S Young
1Charlottesville-Albemarle Rescue Squad, and Department of Emergency Medicine, University of Virginia Health Sciences Center, USA.
Abstract:
Abscess of the psoas muscle is infrequently encountered. An infectious emergency of this type usually presents in a nonspecific manner and thus poses a significant diagnostic challenge to the emergency physician. Diagnosis and specific treatment are often delayed, which can lead to increased mortality. This case report presents a patient with altered mental status and hypotension after a fall, who was initially managed as a trauma victim. Emergency department evaluation initially focused on a traumatic etiology of the above abnormalities. Subsequent assessment determined that the patient's condition was due to an underlying psoas abscess with sepsis. Appropriate anatomy, clinical presentation, and management are discussed in hopes of increasing physician awareness of this uncommon infectious condition.
Insights
Psoas muscle abscesses are rare infectious emergencies that present nonspecifically, often delaying diagnosis and treatment. This case highlights a patient initially treated for trauma who was found to have a life-threatening psoas abscess with sepsis.
Area of Science:
- Emergency Medicine
- Infectious Diseases
- Diagnostic Imaging
Background:
- Psoas muscle abscesses are uncommon but serious infections.
- Nonspecific symptoms can mimic other conditions, complicating diagnosis.
Observation:
- A patient presented with altered mental status and hypotension post-fall, initially presumed to be trauma-related.
- Initial emergency department workup focused on traumatic injuries.
Findings:
- Further assessment revealed the patient's critical condition was caused by a psoas abscess with sepsis.
- The abscess, not the fall, was the primary source of the patient's illness.
Implications:
- Increased physician awareness of psoas abscesses is crucial for timely diagnosis and treatment.
- Prompt recognition and management can reduce mortality associated with this condition.