J Korean Soc Spine Surg.  2010 Dec;17(4):191-197. 10.4184/jkss.2010.17.4.191.

Clinical Availability, Diagnosis and Treatment of the Primary Psoas Muscle Abscess

• An KC
• Kim CW
• Min YK

• KMID: 2209582
• DOI: http://doi.org/10.4184/jkss.2010.17.4.191

Abstract

STUDY DESIGN: This is a retrospective study on the clinical availability, diagnosis and treatment of primary psoas muscle abscess.
OBJECTIVES
This study investigated the causes and clinical results of patients with primary psoas muscle abscess. SUMMARY OF LITERATURE REVIEW: Primary psoas muscle abscess is not a common disease clinically, but it is a very dangerous disease if the diagnosis and treatment are delayed.
MATERIALS AND METHODS
Between October 2003 and February 2010, we investigated the symptoms, pathogens, the associated diseases and treatments of 17 patients (11 males and 6 females; mean age: 49.5 years old). We divided patients into the 3 groups According to the treatment options (Group 1: antibiotics alone, Group 2: percutaneous catheter drainage, Group 3: open drainage) and the correlation of the abscess size of each group was analyzed by the Kruskall Wallis method.
RESULTS
The most common complaint was lower back pain (14 patients). Staphylococcus aureus was the most common infectious organism (12 patients). All the patients were treated with broad spectrum antibiotics. Group 1 was composed of 4 patients and the average size of the abscess was 2.3cm (range: 1.2~4.5cm). Group 2 was composed of 7 patients and the average size of the abscess was 7.4cm (range: 3.8~12.2cm). Group 3 was composed of 6 patients and the average size of the abscess was 8.1cm (range: 6.1~14.7cm). There was a significant correlation of the abscess size between each group. (p=0.0007)
CONCLUSIONS
The patients diagnosed with primary psoas muscle abscess complained about lower back pain, a febrile sense and gastrointestinal symptoms. Most of the primary psoas muscle abscesses are pyogenic infections. We have to use broad-spectrum antibiotics for the initial treatment. When the occasion demands, additional treatment like percutaneous catheter drainage and open drainage should be considered.

Keyword

Psoas muscle abscess; Lower back pain; Febrile sense

MeSH Terms

Abscess
Anti-Bacterial Agents
Catheters
Drainage
Humans
Low Back Pain
Male
Psoas Muscles
Retrospective Studies
Staphylococcus aureus
Anti-Bacterial Agents

Figure

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  Fig.1. (A) Transverse contrast-enhanced CT scan shows a hypodense lesion with enhancing rim in the left psoas muscle, typically an abscess. (B) Coronal T2-weighted MRI scan shows a septated abscess in the left psoas muscle

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  Fig.2. (A) Coronal contrast-enhanced CT scan shows a large hypodense lesion with enhancing rim in the right psoas muscle, typically an abscess (B) Post 3 days of PCD insertion, Coronal contrast-enhanced CT scan shows a decreased amount of abscess in the right psoas muscle

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