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The iliopsoas abscess: aetiology, therapy, and outcome

Abstract number: P1638

Turunc T., Demiroglu Y.Z., Turunc T., Aliskan H., Colakoglu S., Arslan H.

Objective: Iliopsoas abscesses are suppurative collections within the fascia surrounding the psoas and iliacus muscles. Psoas abscess is regarded as a rare disease in the medical literature. The incidence of psoas abscess is not known, but it has probably increased in recent years. In this report we describe 13 cases of psoas abscess presenting to a university hospital in Turkey in the last five years.

Methods: We reviewed clinical data about patients diagnosed with a psoas abscess from June 2001 to June 2004 at Baskent University Faculty of Medicine, Adana, Turkey.

Results: The median age of the patients was 47.8 years (range: 18–70 years) with a male to female ratio of 8/5. Out of 13 patients, one had primary psoas abscess, while 12 had secondary psoas abscess. The predisposing conditions were diabetes mellitus, pancreatic carcinoma, autoimmune hepatitis, sickle cell anaemia and chronic renal failure. Of twelve cases of psoas abscess secondary to vertebral osteomyelitis, five had tuberculosis, one had brucellosis and six had urinary tract infection. The most common complaints were fever and lower back pain. The causative agent was isolated in psoas abscess cultures of 10 cases (Mycobacterium tuberculosis in 5 cases, Brucella melitensis in 1 case, Acinetobacter baumannii in 1 case, meticillin sensitive Staphylococcus aureus in 2 cases and meticillin resistant S. aureus in 1 case). Culture results were negative in two patients and it was not possible to obtain specimen from one patient. Eleven patients underwent percutaneous drainage, which was successful in all cases. Two patients were treated with surgical drainage.

Conclusion: With the advent of modern imaging techniques, the diagnosis of psoas abscess without typical clinical symptoms has become easier. However, despite the improvement in diagnostic techniques, this disease remains a problem as the development of abscesses is often associated with an underlying chronic illness. It is striking that in our series none of the patients had psoas abscess secondary to a disease of the digestive tract, while this is the most common cause of secondary psoas abscess in the literature. Even if the incidence of tuberculosis is actually increasing, tuberculosis abscesses are rare in Western countries. However, it should be kept in mind that Brucellosis and Tuberculosis can be the cause of psoas abscess in developing countries like Turkey where tuberculosis and brucellosis are still endemic.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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