J Korean Pain Soc.  2002 Dec;15(2):168-172.

Psoas Abscess Due to Staphylococcus aureus: A case report

• Lim KJ
• Kim SH

Abstract

We report a case of a primary psoas abscess in a 67-year-old man with a 3 week history of severe low backache that was managed conservatively without surgical drainage. Apart from the positive Patrick's sign and the difficulty in estimating the left straight leg raising due to severe pain, his neurological examination was within normal limits. An epidural nerve block was performed to manage the pain so magnetic resonance imaging (MRI) could be done. MRI showed a foraminal narrowing of the left L3-L4, L4-L5 and a left-sided psoas abscess. An aspiration biopsy of the abscess material under computerized tomography (CT) isolated Staphylococcus aureus, which responded to appropriate therapy with complete resolution. A high index of suspicion is necessary for diagnosing a psoas abscess, which should be considered in patients with pyrexia and backache with a neurological examination for both the surgical and non-surgical approaches.

Keyword

CT; MRI; Psoas abscess; Stapylococcus aureus

MeSH Terms

Abscess
Aged
Back Pain
Biopsy, Needle
Drainage
Fever
Humans
Leg
Low Back Pain
Magnetic Resonance Imaging
Nerve Block
Neurologic Examination
Psoas Abscess*
Staphylococcus aureus*
Staphylococcus*