[Psoas abscess: report of 8 cases and review of the literature].Rev Clin Esp. 1995 May; 195(5):289-93.RC
Eight cases of psoas abscesses (PA) are reported and a comparative study is made with other series as well as a review of the literature. Cases in our series are analysed and an assessment is made of microbiological etiologies, the presence of an origin and its spreading into the surrounding tissues or their primary character, and particularly the diagnostic and therapeutic usefulness of CT-guided percutaneous drainage. Diagnosis was ascertained by CT in all seven cases in which it was performed; percutaneous drainage was performed in five cases and allowed the microbiological categorization of the abscess and an appropriate antibiotic therapy. Laparotomy was performed in only one case; and in two other cases only antibiotics were administered. A favourable outcome occurred in seven out of the eight cases. One of the two patients treated with antibiotics only died. Blood cultures were positive in only three patients. In summary, PA in our series were secondary to bone, urologic or digestive origins in 87.5% of cases. With regard to the causative agent, 37.5% of cases were caused by S. aureus and 50% by gram negative and/or anaerobic organisms. The diagnostic yields of echocardiography and CT were 40% and 100%, respectively. Percutaneous drainage ascertained the microbiological diagnosis in 100% of cases when it was performed, as well as a therapeutic regimen associated with the use of antibiotics. No relapses were recorded in the follow-up of patients. Therefore, we believe that therapy of PA should be based on the association of percutaneous drainage and antibiotics.