Psoas abscess secondary to discitis: a case report of conservative management.
We report a case of secondary psoas abscess in a 37-year-old man with a 3-week history of severe low backache managed conservatively without surgical drainage. Apart from bilaterally restricted straight leg raising (<70 degrees), his neurologic examination was within normal limits. Magnetic resonance imaging showed discitis of the L3-L4 space and a left-sided secondary psoas abscess. Aspiration biopsy of the abscess material under radiologic control isolated Staphylococcus aureus, which responded to appropriate antibiotic therapy with complete resolution. A high index of suspicion is necessary for diagnosis of psoas abscess, which should be considered in patients with pyrexia and backache with a neurologic examination that is otherwise normal. We discuss the recommendations for surgical and nonsurgical approaches.
Qureshi
N H
NH
Department of Neurosurgery, Beaumont Hospital, Dublin, Ireland.
O'Brien
D P
DP
Allcutt
D A
DA
D000038:Abscess / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D000328:Adult; D015299:Discitis / Q000150:complications* / Q000382:microbiology; D006801:Humans; D017116:Low Back Pain / Q000209:etiology / Q000382:microbiology; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D016658:Psoas Muscles / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000209:etiology / Q000628:therapy*