Primary iliopsoas abscess and pregnancy.
BACKGROUND
Iliopsoas abscesses, a rare complication in pregnancy, typically present as a secondary infection due to direct spread of another nearby infection.


METHODS
A 30-year-old multigravid patient with a 10-year history of intravenous heroin use and chronic lower-back pain, presented at 23 0/7 weeks of gestation with multiple cutaneous abscesses. As her back pain worsened during antepartum hospitalization, a primary iliopsoas abscess with underlying osteomyelitis was identified requiring percutaneous computed tomography-guided drainage along with extended-course intravenous antibiotics. After treatment and methadone detoxification, her pregnancy resulted in a successful vaginal delivery.


CONCLUSIONS
Primary iliopsoas abscess should be considered in the differential diagnosis of low-back pain among high-risk pregnant women. Clinicians should be vigilant in identifying high-risk factors and aggressive in treating this rare and potentially fatal complication.
Nelson
David B
DB
From the Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Parkland Health and Hospital System, Dallas, Texas.
Manders
Dustin B
DB
Shivvers
Stephan A
SA
D000328:Adult; D005260:Female; D006556:Heroin Dependence / Q000628:therapy*; D006801:Humans; D010019:Osteomyelitis / Q000150:complications; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000628:therapy*; D016659:Psoas Abscess / Q000175:diagnosis / Q000628:therapy*