Psoas abscess secondary to discitis: a case report of conservative management

J Spinal Disord. 2000 Feb;13(1):73-6. doi: 10.1097/00002517-200002000-00014.

Abstract

We report a case of secondary psoas abscess in a 37-year-old man with a 3-week history of severe low backache managed conservatively without surgical drainage. Apart from bilaterally restricted straight leg raising (<70 degrees), his neurologic examination was within normal limits. Magnetic resonance imaging showed discitis of the L3-L4 space and a left-sided secondary psoas abscess. Aspiration biopsy of the abscess material under radiologic control isolated Staphylococcus aureus, which responded to appropriate antibiotic therapy with complete resolution. A high index of suspicion is necessary for diagnosis of psoas abscess, which should be considered in patients with pyrexia and backache with a neurologic examination that is otherwise normal. We discuss the recommendations for surgical and nonsurgical approaches.

Publication types

  • Case Reports

MeSH terms

  • Abscess / diagnosis
  • Abscess / etiology*
  • Abscess / therapy*
  • Adult
  • Discitis / complications*
  • Discitis / microbiology
  • Humans
  • Low Back Pain / etiology
  • Low Back Pain / microbiology
  • Lumbar Vertebrae
  • Magnetic Resonance Imaging
  • Male
  • Psoas Muscles / microbiology*
  • Staphylococcal Infections / etiology
  • Staphylococcal Infections / therapy*