J Korean Orthop Assoc.  2007 Aug;42(4):553-555. 10.4055/jkoa.2007.42.4.553.

The Recurrent Psoas Abscess Caused by Two Different Pathogens: A Case Report

• Jeon CH
• Jeoung US
• Chung GY
• Kim SH

• KMID: 2186519
• DOI: http://doi.org/10.4055/jkoa.2007.42.4.553

Abstract

We report a case of a recurrent psoas abscess caused by two different pathogens. The abdominal CT scans revealed a multiseptated cystic mass along the right psoas-iliacus muscle. The patient was treated with antibiotics treatment in combination with CT-guided percutaneous aspiration and drainage using a catheter. The microbiological examination revealed Klebsiella pneumoniae. Six months later, the patient presented with anorexia, malaise, epigastric pain, lower back pain and fever of 37.8 degrees C for a one-week duration. The abdominal CT scans revealed an abscess cavity on the inferior side of the right psoaos-iliacus muscle. This was accompanied by retrocecal appendicitis and a periappendiceal abscess. Magnetic resonance imaging of the pelvis showed that the psoas abscess was located on the right psoas-iliacus muscle. We performed an appendectomy and laparotomy. Subsequently, the culture yielded Escherichia coli in the psoas abscess. To our knowledge, this is the first case of a recurrent psoas abscess caused by two different pathogens.

Keyword

Recurrent psoas abscess; Different pathogens; Appendicitis

MeSH Terms

Abscess
Anorexia
Anti-Bacterial Agents
Appendectomy
Appendicitis
Catheters
Drainage
Escherichia coli
Fever
Humans
Klebsiella pneumoniae
Laparotomy
Low Back Pain
Magnetic Resonance Imaging
Pelvis
Psoas Abscess*
Tomography, X-Ray Computed
Anti-Bacterial Agents

Figure

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  Fig. 1 Contrast-enhanced abdominal CT scans showing a multiseptated cystic mass along right psoas-iliacus muscle.

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  Fig. 2 Contrast-enhanced abdominal CT scans showing that the right psoas-iliacus abscess is almost resolved with CT-guided percutaneous drainage.

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  Fig. 3 Contrast-enhanced abdominal CT scans shows that the psoas abscess was accompanied by retrocecal appendicitis and a periappendiceal abscess (arrow) (A). In addition, the abscess cavity was observed on the inferior side of the right psoaos-iliacus muscle (B).

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