Primary iliopsoas abscess in a diabetic patient

Abstract

A 69-year-old man with a history of type 2 diabetes, cerebral infarction, lumbar spinal canal stenosis, and herniated disk presented with progressive left-sided lower back pain over a few days. He had no history of trauma or recent skin infection. On clinical examination, he had high-grade fever (38·2°C) and a psoas posture. Laboratory showed leucocytosis (white-cell count 11·1 × 109 cells per L) and raised C-reactive protein concentration (352·39 nmol/L). Contrast-enhanced CT of the abdomen after plain CT showed a swollen left iliopsoas muscle containing fluid (figure A, arrows).