Obturator internus abscess in adults: A broad approach to diagnosis.

Abstract

A 55-year-old male presented to the emergency department with a 2-week history of atraumatic right hip and groin pain, subjective fevers as well as reduced weight bearing on his right leg. His medical background was significant for active intravenous (IV) drug use (injection via groin) and alcohol abuse, untreated hepatitis C, pericarditis and previous Staphylococcus bacteraemia. The initial examination was significant for tenderness of the right hip on palpation with extreme pain on flexion, abduction and adduction. The patient's abdomen was soft and non-tender and no herniae were identified. Initial blood tests revealed a white cell count of 15 × 109/L and C-reactive protein was 3.4 mg/L. Two sets of blood cultures were done on admission and were negative for microbial growth. Computed tomography (CT) imaging showed an undisplaced fracture through the right superior pubic ramus and oedema in the right obturator internus (Fig. 1).