Psoas Abscess Research Articles

A Case of Pott’s Disease Complicated by Tuberculous Meningitis and Psoas Abscess Diagnosed by Computed Tomography-Guided Percutaneous Drainage

A Case of Pott’s Disease Complicated by Tuberculous Meningitis and Psoas Abscess Diagnosed by Computed Tomography-Guided Percutaneous Drainage

Disseminated Tuberculosis in an Immunocompetent Adult: A Rare Clinical Presentation and Diagnostic Challenge

Disseminated tuberculosis (TB) is a rare and life-threatening form of TB, particularly when it occurs in immunocompetent individuals. A 52-year-old diabetic male presented with tachypnea, tachycardia, and chronic low back pain. Comprehensive imaging revealed pulmonary involvement, lumbosacral vertebral destruction (L5-S1), genitourinary TB, hepatitis, and psoas abscesses. Ultrasound-guided drainage and CB-NAAT analysis confirmed Mycobacterium tuberculosis. Given the patient's deranged liver function tests, a modified antitubercular therapy regimen, including levofloxacin, amikacin, and ethambutol, was administered. The patient demonstrated significant clinical improvement, with resolution of symptoms and normalization of liver function on follow-up. This case underscores the diagnostic complexity of disseminated TB in immunocompetent patients, highlighting the importance of early detection and individualized treatment. Further research is needed to develop standardized treatment protocols, particularly for cases involving multi-organ involvement and liver dysfunction.

A case report of bilateral psoas abscess with co-existing gluteal abscess in Pott`s disease of the spine in a middle-aged woman in a Specialist Hospital

Psoas abscess (PA) is the buildup of suppurative fluid in the fascia surrounding the psoas/iliopsosas muscle, is a rare condition, with diagnostic difficulty. Pott`s disease also called spinal tuberculosis occurs due to extra pulmonary tuberculosis. Backpain, fever, weight loss, lump in the groin and limping are its main symptoms. Curable by administering antitubercular therapy and sensitive antimicrobials with analgesics for indicative relief. Surgical procedures can be carried out to eliminate the accrued fluid based on the inter individual degree of presentation. In this case report, we report a rare case of bilateral psoas abscess with co-existing gluteal abscess and Potts’s disease. A 48-year old female presented with complaints of backpain, limping, lump in the flank/buttock and fever of two weeks. Abdominopelvic computed tomography scan showed massive right iliopsoas muscle collection with extension into the ipsilateral gluteal region and subcutaneous tissue. Similar collection was seen in the left psoas muscle superiorly. The bone window of the lumbosacral spine showed the anterior wedged collapse of the vertebral bodies with gibbus deformity. The patient had spontaneous rupture of the gluteal collection and surgical drainage of the right iliopsoas and left psoas collection was done. Anti-Kochs therapy was commenced and patient is currently doing great. The introduction of computed tomography (CT) and magnetic resonance imaging (MRI) has greatly improved the diagnosis of psoas abscess with Pott`s disease or in its isolated forms.

Infected Primary Bone Mantle Cell Lymphoma with Multiple Vertebral Involvement

Primary vertebral lymphoma is an exceedingly rare entity. We hereby report a case of a 67-year-old male who presented to our department with fever, weight loss, and progressively worsening lower back pain radiating to the right hip. Physical examination showed pain on percussion of the dorsal and lumbar spine and tenderness on palpation of the right upper thigh area. The radiographic findings revealed numerous vertebral lesions with a right psoas abscess extending to the right upper thigh. Intravenous antibiotic therapy was initiated and the patient underwent an incision and drainage of the psoas abscess with a favourable outcome. However, given the suspicious imaging findings of the osseous lesions suggestive of malignancy, a vertebral biopsy was performed and yielded histo-pathological findings consistent with bone mantle cell lymphoma. To the best of our knowledge, this is the first case of an infected primary bone mantle cell lymphoma with multiple vertebral involvement. The diagnosis is challenging and can be confused with other diseases.

Silent Shadows: Unveiling the Psoas Abscess and Its Treatment

Silent Shadows: Unveiling the Psoas Abscess and Its Treatment

Psoas Abscess Presenting as a Cause of Small Bowel Obstruction in an Adult: A Diagnostic Challenge

Psoas Abscess Presenting as a Cause of Small Bowel Obstruction in an Adult: A Diagnostic Challenge

MRI findings and classification of brucella spondylitis: a China multicenter study.

To propose a magnetic resonance imaging (MRI) classification of brucellosis spondylitis (BS) to determine a standard treatment method and a standard of post-treatment MRI follow-up. This is a multicenter retrospective cohort study. All patients diagnosed with BS at six hospitals for 12years, were included in the study. Data were collected retrospectively from the medical records of the patients. The classification of the cases was based on MRI. We analyzed MRI features of BS was categorized them into three types. Six hundred fifteen patients were included in the study, 78.9% of whom were males. The mean age was 53.05 ± 11.06years. Involvement of single vertebrae occurred in 6.2% of patients, while 72.7% involved two vertebrae and 21.1% involvement of more than two vertebrae. The most common of the lumbar spine was 64.6%. The main findings of MRI were affected vertebral endplate 2/3 above (60.7%), intervertebral space narrow (77.9%), intervertebral disc involvement (83.6%), paravertebral abscess (50.9%), disc abscess (49.6%), epidural abscess (43.3%), vertebra height change (22.1%), psoas abscess (22.0%), and abnormal vertebral accessory (10.2%). MR imaging of BS was categorized into three types. Type I: 57 (9.3%) patients; Type II: 526 (85.5%) patients, including IIa (26.5%), IIb (36.9%), and IIc (22.1%); Type IV: vertebral appendage type, 63 (10.2%) cases; Type III: 32 (5.2%) patients. MRI features of multicenter data can provide theoretical support for diagnosing BS. MRI classification of BS can afford better help for clinical treatment and follow-up after clinical treatment.

Bilateral tuberculosis psoas abscess in a human immunodeficiency virus-positive patient: a case report

BackgroundWorldwide, there is an increase in the frequency of reports of psoas abscesses due to advances in imaging technology, which has led to early diagnosis and treatment. A bilateral psoas abscess is rare and, when it occurs, is usually secondary and in immunocompromised patients. We present a case of a bilateral tuberculosis psoas abscess in a human immunodeficiency virus-positive patient.Case presentationA 21-year-old Ugandan female undergraduate who contracted human immunodeficiency virus through vertical transmission and has been on highly active antiretroviral drugs presented with bilateral lower abdominal pain with associated fever and headache. Clinical examination revealed abdominal tenderness in both iliac fossae with palpable masses. Ultrasonography revealed fluid collection in both psoas muscles confirming bilateral abscesses. The aspirate was acid-fast bacilli positive. A diagnosis of bilateral tuberculosis psoas abscess was made. Open drainage was performed and antituberculosis drugs were commenced.ConclusionsBilateral tuberculosis psoas abscesses occurring in human immunodeficiency virus-positive patients, although uncommon, is not unexpected. It is a form of secondary psoas abscess in immunocompromised patients. Here, the outcome was successful with a combination of early surgical drainage and appropriate medical therapy.

Disseminated tuberculosis complicated by intramuscular abscesses, meningoencephalitis, and hemophagocytic lymphohistiocytosis: a case report

BackgroundAs disseminated extrapulmonary tuberculosis infection can involve multiple systems and result in atypical clinical manifestations that mimic other diseases, the diagnosis may be difficult, especially in elderly patients. Delaying treatment can adversely affect the prognosis. And to achieve better prognosis, early detection and diagnosis are necessary, as well as early initiation of comprehensive treatment.Case presentationWe present the case of a 78-year-old man with disseminated tuberculosis who developed the uncommon complication of urinary retention due to a psoas abscess, meningoencephalitis, and the rare secondary hemophagocytic lymphohistiocytosis syndrome. The patient achieved a favorable outcome following targeted therapy with antitubercular medications.ConclusionsThis case highlights that disseminated extrapulmonary tuberculosis infection can present with a variety of manifestations, and may exhibit many rare and complex clinical presentations. Prompt and accurate diagnosis and treatment play a crucial role in improving prognosis for the patients with persistent fever.

Bilateral Psoas Abscess Extended into Spinal Canal in a Patient with Long-Standing Poorly Controlled Diabetes Mellitus – A Case Report

Bilateral Psoas Abscess Extended into Spinal Canal in a Patient with Long-Standing Poorly Controlled Diabetes Mellitus – A Case Report

Evaluating Imaging Techniques for Diagnosing and Drainage Guidance of Psoas Muscle Abscess: A Systematic Review.

Background: Psoas muscle abscess (PMA) is an uncommon yet severe condition characterized by diagnostic and therapeutic challenges due to its varied etiology and nonspecific symptoms. This study aimed to evaluate the effectiveness and accuracy of various imaging techniques used in the image-guided percutaneous drainage (PD) of PMA. Methods: A systematic review was conducted following the PRISMA guidelines. We searched PubMed, Google Scholar, and Science Direct for studies published in English from 1998 onwards that reported on the use of PD in treating PMA, detailing outcomes and complications. Imaging modalities guiding PD were also examined. Results: We identified 1570 articles, selecting 39 for full review. Of these, 23 met the inclusion criteria; 19 were excluded due to unspecified PMA, absence of imaging guidance for PD, or inconclusive results. Eleven studies utilized computed tomography (CT) for PD, with six also using magnetic resonance imaging (MRI). Ten studies implemented ultrasound (US)-guided PD; variations in diagnostic imaging included combinations of US, CT, and MRI. A mixed approach using both CT and US was reported in two articles. Most studies using CT-guided PD showed complete success, while outcomes varied among those using US-guided PD. No studies employed MRI-guided PD. Conclusions: This review supports a multimodal approach for psoas abscess management, using MRI for diagnosis and CT for drainage guidance. We advocate for Cone Beam CT (CBCT)-MRI fusion techniques with navigation systems to enhance treatment precision and outcomes, particularly in complex cases with challenging abscess characteristics.

Tuberculous Spondylodiscitis with Psoas Abscess Descending into the Anterior Femoral Compartment Identified Using 2-deoxy-2-[18F]fluoroglucose Positron Emission Tomography Computed Tomography.

A 24-year-old immunocompetent woman underwent whole-body 18F-FDG PET/CT for the evaluation of MRI-suspicious tuberculous spinal lesions. The PET/CT results showed no pathological uptake in either lung, and there were no pathological changes on CT. There was increased uptake in the right psoas muscle, extending continuously down anterior to the right hip joint, posterior to and around the trochanteric region of the right femur, and into the right thigh, with an SUVmaxbw of 17.0. Subsequently, the patient underwent CT-guided biopsy as per protocol, which revealed drug-sensitive Mycobacterium tuberculosis, and the patient was started on standard tuberculosis treatment for 12 months.

Miliary Tuberculosis Presenting With Meningitis, Tuberculomas, Osteomyelitis, Psoas Abscesses, and Pulmonary Involvement

Miliary Tuberculosis Presenting With Meningitis, Tuberculomas, Osteomyelitis, Psoas Abscesses, and Pulmonary Involvement

Psoas Abscess Extended to the Anterolateral Abdominal Wall Complicating Acute Appendicitis

A psoas abscess is a purulent collection of the psoas muscle, most often secondary to a locoregional infectious focus that may be intra- or retroperitoneal. Appendicitis ranks second (16%) after crohn's disease (60%) among digestive etiologies of psoas abscesses. Its etiological diagnosis can prove difficult. Imaging is therefore essential. We report the case of a psoas abscess extending to the anterolateral abdominal wall complicating acute appendicitis in a 24-year-old female patient admitted to the emergency department for an appendicular syndrome associated with psoitis. Imaging (abdominal CT scan) showed a huge collection in the psoas muscle extending to the right anterolateral abdominal wall. The procedure consisted of appendectomy with copious lavage and drainage with two delbet blades.

Rapid pulmonary fistulization complicating a psoas abscess with intraoperative hypoxemia: a rare case report

Introduction and importance: Psoas abscess is a relatively uncommon condition that can present with vague clinical features. Patients with this condition often present in different ways to different specialties leading to delays in diagnosis and management. Case presentation: We present a 47-year-old woman with complaint of vague abdominal pain, fever and raised inflammatory markers who underwent CT examination. On CT, a collection was noted in the right iliac fossa that extended along the right retroperitoneum through the retrocrural space in the right lung base communicating with a cavitary pulmonary lesion with air-fluid level. The psoas abscess was drained. Clinical discussion: Our case presents a number of rare and intriguing features. Notably, the patient, who was immunocompetent, experienced a primary Staphylococcus infection that swiftly progressed to a sizable pulmonary abscess, a phenomenon uncommon in such hosts. The rarity further extends to the source of infection, originating abdominally but culminating in thoracic complications through contiguous spread from a retroperitoneal site. Despite the potential severity, the patient’s outcome was remarkably positive Conclusion: This case underscores the potential rapidity of pulmonary involvement in psoas abscesses, emphasizing the need for heightened awareness and consideration of respiratory signs during preoperative assessments

Abscess of Psoas in Children at Gabriel Toure Chu: About 31 Cases

Abscess of Psoas in Children at Gabriel Toure Chu: About 31 Cases

A case report of endovascular treatment of a fast-growing inflammatory abdominal aortic aneurysm in a patient with Staphylococcus aureus sepsis

Abdominal Aortic Aneurysm (AAA) and its subsequent rupture is one of the life-threatening conditions. The most common type of arterial aneurysm, AAA, becomes significant at a diameter greater than 3 cm. The mean growth rate of an AAA is 2-3 mm per year, and surgical repair is usually recommended if the diameter exceeds 5.5 cm, in men and 5.0 to 5.2 cm, in women. Faster-growing aneurysms are more aggressive and have a greater risk of rupture. We report a case of a 64-year-old, comorbid male patient who was found to have a previously unknown, but a rapidly growing AAA, which grew from 6cm to 8 cm within just 3 weeks. He was admitted in the emergency department with complaints of worsening dyspnea even without exertion. Upon thorough diagnostic tests, the severity of the overall medical condition was determined by S. aureus sepsis, decompensation of cardiovascular disease, and secondary kidney injury due to septic shock. While receiving treatment for sepsis, a diagnostic CT imaging was done, which confirmed bilateral pneumonia and retroperitoneal abscess in m. psoas major mass, and an infrarenal abdominal aortic aneurysm, which was 6cm in diameter at the time of diagnosis. Another control CT of the lungs and abdomen was performed three weeks later, indicating the pneumonia was slowly resolving, while the aortic aneurysm increased in dynamic; the diameter was 8 cm with a penetrating exudation on the left side, m. psoas abscess was still observed, but decreasing. Because the AAA was very fast-growing, it greatly increased the risk of its rupture, therefore a decision was made to perform endovascular abdominal aortic aneurysm repair, despite the risk of stent infection, given the patients septic background. The goal of this case report is to highlight the rare case of a rapidly growing inflammatory aneurysm and its successful endovascular management. While it’s known that 5-10% of all AAA are inflammatory, cases of surgical treatment in the setting of sepsis are basically non-existent in the literature [1].

A comparative perspective on brucellar, pyogenic, and tuberculous spondylodiscitis.

Non-specific features of spondylodiscitis lead to a delay and challenge in the diagnosis/differential diagnosis/treatment processes, and thus, serious complications may arise. This study aims to compare brucellar, pyogenic, and tuberculous types of spondylodiscitis, considering their demographic, clinical, and laboratory differences. This may provide more rapid management and good outcomes. A total of 131 patients with infectious spondylodiscitis were included in the study. The patients were divided into brucellar (n=63), pyogenic (n=53), and tuberculous (n=15) types of spondylodiscitis and compared for demographic, clinical, laboratory, and imaging features. Tuberculous spondylodiscitis had higher scores for weight loss, painless palpation, thoracic spine involvement, and psoas abscess formation than other spondylodiscitis. Also, tuberculous spondylodiscitis had higher rates of neurologic deficit and lower rates of lumbar involvement than brucellar spondylodiscitis. Pyogenic spondylodiscitis is more likely to occur in patients who have a history of spine surgery compared to other forms of spondylodiscitis. Also, pyogenic spondylodiscitis had higher rates of fever, erythema, paraspinal abscess, white blood cell (WBC), and erythrocyte sedimentation rate (ESR) than brucellar spondylodiscitis. On the other hand, brucellar spondylodiscitis had higher rates of rural living and sweating than pyogenic spondylodiscitis. Weight loss, painless palpation, involved thoracic spine, psoas abscess, and neurologic deficit are symptoms favoring tuberculous spondylodiscitis. History of spine surgery, high fever, skin erythema, and paraspinal abscess are findings in favor of pyogenic spondylodiscitis. Rural living, sweating, and involved lumbar spine are symptoms that indicate brucellar spondylodiscitis. These symptoms can be used to distinguish the types of spondylodiscitis.

Psoas Abscess in a Snowboarder: A Musculoskeletal Manifestation of Crohn's Disease.

Psoas Abscess in a Snowboarder: A Musculoskeletal Manifestation of Crohn's Disease.

Insidious Spinal Brucellosis and Psoas Abscess in a 67-Year-Old Patient: A Case Report

Insidious Spinal Brucellosis and Psoas Abscess in a 67-Year-Old Patient: A Case Report