Primary bilateral iliopsoas abscess in an elderly man.
Primary bilateral iliopsoas abscesses in the elderly are very rare in Europe. We report a case of an elderly male misdiagnosed with rheumatic low back pain. The delay in accurate diagnosis and therapy led to severe worsening of his general condition and septic shock. The diagnosis was established by multi-slice computed tomography (MSCT) and the patient was successfully treated by MSCT-guided percutaneous drainage of both psoas muscles. Septic shock and miscellaneous complications required continuous intensive care. The patient was discharged after 42 days of hospital treatment. Antibiotic therapy continued for the next six weeks until his complete recovery. Pain remains the most frequent and predominant symptom of spinal pathology regardless of the etiology. Immunocompromised patients or signs suggestive of bacterial infection require caution and a more comprehensive diagnostic work-up.
Department of Emergency Medicine, University Department of Medicine, Sestre milosrdnice University Hospital, Zagreb, Croatia. zeljko.vucicevic@zg.t-com.hr
Zeljko
Z
Vucicević
Borislav
B
Spajić
Nenad
N
Babić
Vesna
V
Degoricija
D000368:Aged; D003951:Diagnostic Errors; D004322:Drainage; D006801:Humans; D017116:Low Back Pain / Q000150:complications; D008297:Male; D061330:Multidetector Computed Tomography; D016659:Psoas Abscess / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy