Clinical Presentations, Diagnosis, and Treatments of a Psoas Abscess.
- Author:
Chang Bae PARK
1
;
Kyu Seok KIM
;
Jung Ho SHIN
;
Gil Joon SUH
;
Yeo Kyu YOUN
Author Information
1. Department of Emergency Medicine, Seoul National University, College of Medicine, Seoul, Korea. suhgil@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Psoas abscess
- MeSH:
Abscess;
Acupuncture;
Adult;
Anti-Bacterial Agents;
Back Pain;
Diagnosis*;
Drainage;
Emergency Service, Hospital;
Epidural Abscess;
Femoral Neuropathy;
Fever;
Humans;
Leukocytosis;
Magnetic Resonance Imaging;
Nerve Block;
Psoas Abscess*;
Retrospective Studies
- From:Journal of the Korean Society of Emergency Medicine
2005;16(3):346-351
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: A psoas abscess is a rare, but life-threatening disease. We report 11 cases of a psoas abscess in adults and discuss its clinical presentations, diagnosis, and treatments. METHODS: Retrospective analysis of patients who presented to the emergency department with a psoas abscess from Jan. 2000 to Aug. 2004 was conducted. RESULTS: Of the 11 patients with a psoas abscess, 9 (81.8%) had a secondary psoas abscess. The most common causes of the secondary psoas abscess were various invasive procedures, such as acupuncture, a nerve block, etc. The main clinical presentations were fever (72.7%) and back pain (45.5%). The mean time to presentation was 12.0+/-10.6 days. All patients had leukocytosis and elevated CRP. Computed tomography (81.8%) and magnetic resonance imaging (18.2%) were performed for the diagnosis. The mean diagnostic lag time (from admission to the treatment) was 7.8+/-7.5 days. All patients received intravenous antibiotics. Four patients (36.4%) underwent surgical drainage, and three patients (27.3%) underwent percutaneous drainage. Two patients (18.2%) were treated with simple aspiration, and another two (18.2%) received no procedure. Six patients (54.5%) had complications. Three (27.3%) had a recurrent abscess, and two (18.2%) had a epidural abscess. In one patient, femoral neuropathy developed. The time from clinical presentation to diagnosis in the complication associated group was longer than it was in complication non-associated group (27.5+/-19.6 vs 10.6+/-3.2 days, p=0.03). CONCLUSION: A psoas abscess is difficult to diagnose because of vague clinical symptoms and can have serious complications if the diagnosis is missed or delayed.
