Psoas abscess: Analysis of 24 cases.
- Author:
Jung Hyeon CHOI
1
;
Min Cheul KIM
;
Seung Guan IM
;
Suk Kyung CHO
;
Sung Soo SHIN
;
Yoon Jung OH
;
Young Hwa CHOI
;
Kwang Joo PARK
;
Sung Chul HWANG
Author Information
1. Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Korea. yhwa1805@ajou.ac.kr
- Publication Type:Original Article
- Keywords:
Psoas abscess;
Staphylococcal infection;
Tuberculosis
- MeSH:
Abdominal Pain;
Abscess;
Anti-Bacterial Agents;
Back Pain;
Delayed Diagnosis;
Diagnostic Errors;
Drainage;
Enterobacteriaceae;
Fever;
Humans;
Mortality;
Mycobacterium tuberculosis;
Psoas Abscess*;
Retrospective Studies;
Shock, Septic;
Staphylococcal Infections;
Staphylococcus aureus;
Tuberculosis
- From:Korean Journal of Medicine
2003;65(3):343-349
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Psoas abscess is a rare condition with vague clinical presentations, therefore misdiagnosis or delayed diagnosis is often made. We have reviewed the characteristics of the clinical presentation, microbiology, and treatment of 24 patients with psoas abscess. METHODS: The records of all patients treated with psoas abscess at Ajou University Hospital between March, 1996 and May, 2001 were retrospectively reviewed. RESULTS: A total of 24 cases of psoas abscess were reviewed: among these 17 cases were due to secondary cases and seven cases were diagnosed as primary psoas abscess. The right side was affected in 11 cases, the left side in nine, and both sides in four. Methicillin-susceptible Staphylococcus aureus was the most frequent (7/24 cases) pathogen, which were detected in cultures from five of seven patients with primary abscesses, whereas Mycobacterium tuberculosis (6/17 cases) and mixed enteric flora were detected in secondary abscesses. Three of the patients with primary psoas abscess expired from septic shock. The mortality rate was 12.5%. CONCLUSION: A psoas abscess should be considered when any patient presents with nonspecific abdominal pain, back pain and fever. This condition may be diagnosed promptly with computed tomography. Treatment involves use of appropriate antibiotics, as well as drainage of the abscess. Antibiotic coverage must include S. aureus and enteric bacteria. However, in endemic areas (such as Korea), tuberculous infection should be also considered.
