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Psoas abscess: a 10 year review.
J Microbiol Immunol Infect. 1999 Mar; 32(1):40-6.JM

Abstract

Psoas muscle abscesses are rarely encountered yet, and pose diagnostic and therapeutic challenges because of nonspecific clinical presentations. We retrospectively reviewed the medical records of adults with a psoas muscle abscess who were admitted to our hospital from January, 1988 to May, 1998. Over this ten year period, psoas abscesses were found in 11 cases. Six cases were primary and Staphylococcus spp. was the most commonly isolated. Five cases were a secondary psoas abscess while urological problems were the most common underlying condition. Fever, chills, lower back or flank pain and a palpable mass were the most common manifestations. Only one patient presented the classic triad of fever, flank pain, and limitation of hip movement (a typical psoas sign). Leukocytosis was the most common laboratory finding. Two of 11 cases presented septic shock. Two patients were admitted to the hospital with the initial diagnosis of psoas abscesses. Computerized tomographic (CT) scans accurately confirmed the clinical diagnosis in 9 of 11 patients. Diagnosis was then established one each by ultrasound (US) and magnetic resonance imaging (MRI), respectively. Four of 11 patients had negative findings initially by US. All patients were managed with drainage and antibiotics, nine were drained surgically, and two were managed with percutaneous drainage under CT guidance. Two patients died. Because of the lack of the classic symptoms and signs in most cases, a high degree of suspicion is important for early diagnosis of psoas abscess. CT scan is the standard technique of diagnosis. The prognosis is generally good with appropriate antibiotic treatment and complete drainage.

Authors+Show Affiliations

Lee YT
Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan, ROC.
Lee CM
No affiliation info available
Su SC
No affiliation info available
Liu CP
No affiliation info available
Wang TE
No affiliation info available

MeSH

AdultAgedAged, 80 and overAnti-Bacterial AgentsDrainageFemaleHumansMaleMiddle AgedPsoas Abscess

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11561569

Citation

Lee, Y T., et al. "Psoas Abscess: a 10 Year Review." Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi, vol. 32, no. 1, 1999, pp. 40-6.
Lee YT, Lee CM, Su SC, et al. Psoas abscess: a 10 year review. J Microbiol Immunol Infect. 1999;32(1):40-6.
Lee, Y. T., Lee, C. M., Su, S. C., Liu, C. P., & Wang, T. E. (1999). Psoas abscess: a 10 year review. Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi, 32(1), 40-6.
Lee YT, et al. Psoas Abscess: a 10 Year Review. J Microbiol Immunol Infect. 1999;32(1):40-6. PubMed PMID: 11561569.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Psoas abscess: a 10 year review. AU - Lee,Y T, AU - Lee,C M, AU - Su,S C, AU - Liu,C P, AU - Wang,T E, PY - 2001/9/20/pubmed PY - 2001/10/5/medline PY - 2001/9/20/entrez SP - 40 EP - 6 JF - Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi JO - J Microbiol Immunol Infect VL - 32 IS - 1 N2 - Psoas muscle abscesses are rarely encountered yet, and pose diagnostic and therapeutic challenges because of nonspecific clinical presentations. We retrospectively reviewed the medical records of adults with a psoas muscle abscess who were admitted to our hospital from January, 1988 to May, 1998. Over this ten year period, psoas abscesses were found in 11 cases. Six cases were primary and Staphylococcus spp. was the most commonly isolated. Five cases were a secondary psoas abscess while urological problems were the most common underlying condition. Fever, chills, lower back or flank pain and a palpable mass were the most common manifestations. Only one patient presented the classic triad of fever, flank pain, and limitation of hip movement (a typical psoas sign). Leukocytosis was the most common laboratory finding. Two of 11 cases presented septic shock. Two patients were admitted to the hospital with the initial diagnosis of psoas abscesses. Computerized tomographic (CT) scans accurately confirmed the clinical diagnosis in 9 of 11 patients. Diagnosis was then established one each by ultrasound (US) and magnetic resonance imaging (MRI), respectively. Four of 11 patients had negative findings initially by US. All patients were managed with drainage and antibiotics, nine were drained surgically, and two were managed with percutaneous drainage under CT guidance. Two patients died. Because of the lack of the classic symptoms and signs in most cases, a high degree of suspicion is important for early diagnosis of psoas abscess. CT scan is the standard technique of diagnosis. The prognosis is generally good with appropriate antibiotic treatment and complete drainage. SN - 1684-1182 UR - https://www.unboundmedicine.com/medline/citation/11561569/Psoas_abscess:_a_10_year_review_ DB - PRIME DP - Unbound Medicine ER -