Abstract

Case Presentation

Febrile Lumbar Pain Revealing a Massive Collection: Complicated Psoas Abscess Managed Surgically

Mohammed Amine Elafari*, Mamad Ayoub, Mohammed Amine Bibat, Rhayour Anas, Maachi Youssef, Amine Slaoui, Tarik Karmouni, Abdelatif Koutani and Khalid Elkhader

Published: 05 March, 2026 | Volume 10 - Issue 1 | Pages: 010-012

Psoas abscess is a rare but potentially life-threatening condition with non-specific clinical manifestations. The condition may be primary or secondary, depending on whether it has an underlying cause. The condition may be diagnosed with the help of imaging studies, especially contrast-enhanced computed tomography (CT).
A 55-year-old female patient with a history of treated hypertension presented with a 15-day history of fever and left-sided low back pain. Her laboratory parameters showed a high leukocyte count of 22,000 cells/mm³ and elevated levels of C-reactive protein (367 mg/L). Her renal functions were within normal limits, and the urine culture was negative. Contrast-enhanced CT revealed a large left-sided intra-abdominal fluid collection extending from the diaphragm to the left iliac fossa, measuring 66 x 305 mm with air bubbles. The collection also showed a left-sided intramuscular psoas collection of 66 x 50 x 131 mm. The patient received intravenous broad-spectrum antibiotics (third-generation cephalosporin, aminoglycoside, and metronidazole). The patient underwent mini-lumbotomy, and nearly 1 liter of pus was drained. The patient’s postoperative course was satisfactory with complete resolution of symptoms. The histopathological examination showed non-specific changes.
Psoas abscess should be suspected in patients with febrile low back pain and inflammatory syndrome. Contrast-enhanced CT scans are essential for diagnosis and assessment of the extent of disease. In complicated cases with large abscess formation, early surgical drainage along with appropriate antibiotics will provide the best outcome.
This case highlights the importance of early diagnosis and adapted management for successfully navigating the complexities associated with this condition.

Read Full Article HTML DOI: 10.29328/journal.jcmei.1001041 Cite this Article Read Full Article PDF

Keywords:

Psoas abscess; Intra-abdominal collection; Computed tomography; Surgical drainage; Case report

References

  1. Ricci MA, Rose FB, Meyer KK. Pyogenic psoas abscess: worldwide variations in etiology. World J Surg. 1986;10(5):834-843. Available from: https://dx.doi.org/10.1007/BF01655254
  2. Mallick IH, Thoufeeq MH, Rajendran TP. Iliopsoas abscesses. Postgrad Med J. 2004;80(946):459-462. Available from: https://dx.doi.org/10.1136/pgmj.2003.017665
  3. Santaella RO, Fishman EK, Lipsett PA. Primary vs secondary iliopsoas abscess. Presentation, microbiology, and treatment. Arch Surg. 1995;130(12):1309-1313. Available from: https://dx.doi.org/10.1001/archsurg.1995.01430120053008
  4. Navarro López V, Ramos JM, Meseguer V, et al. Microbiology and outcome of iliopsoas abscess in 124 patients. Medicine (Baltimore). 2009;88(2):120-130. Available from: https://dx.doi.org/10.1097/MD.0b013e31819d2748
  5. Cantasdemir M, Kara B, Cebi D, et al. Computed tomography-guided percutaneous catheter drainage of primary and secondary iliopsoas abscesses. Clin Radiol. 2003;58(10):811-815. Available from: https://dx.doi.org/10.1016/S0009-9260(03)00206-7
  6. Zissin R, Gayer G, Kots E, et al. Iliopsoas abscess: a report of 24 patients diagnosed by CT. Abdom Imaging. 2001;26(5):533-539. Available from: https://dx.doi.org/10.1007/s002610000214
  7. Gruenwald I, Abrahamson J, Cohen O. Psoas abscess: case report and review of the literature. J Urol. 1992;147(6):1624-1626. Available from: https://dx.doi.org/10.1016/S0022-5347(17)37506-1
  8. Almana O, Ben Yahia K, Aldhabab A, et al. (December 11, 2023) Pyogenic Psoas Abscess in a Patient With Chronic Low Back Pain: A Case Report. Cureus 15(12): e50330. Available from: https://dx.doi.org/10.7759/cureus.50330
  9. Lin MF, Lau YJ, Hu BS, Shi ZY, Lin YH. Pyogenic psoas abscess: analysis of 27 cases. J Microbiol Immunol Infect. 1999;32(4):261-268.Available from: https://pubmed.ncbi.nlm.nih.gov/10650491/
  10. Tabrizian P, Nguyen SQ, Greenstein A, Rajhbeharrysingh U, Divino CM. Management and treatment of iliopsoas abscess. Arch Surg. 2009;144(10):946-949. Available from: https://dx.doi.org/10.1001/archsurg.2009.144
  11. Shields D, Robinson P, Crowley TP. Iliopsoas abscess—a review and update on the literature. Int J Surg. 2012;10(9):466-469. Available from: https://dx.doi.org/10.1016/j.ijsu.2012.08.016

Figures:

Similar Articles

Recently Viewed

  • Late Extensive Regional Recurrence of Paratesticular Dedifferentiated Liposarcoma 10 Years after Orchiectomy: A Case Report
    Mohammed Amine Elafari*, Mamad Ayoub, Mohammed Amine Bibat, Amine Slaoui, Tariq Karmouni, Abdelatif Koutani and Khalid Elkhader Mohammed Amine Elafari*,Mamad Ayoub,Mohammed Amine Bibat,Amine Slaoui,Tariq Karmouni,Abdelatif Koutani,Khalid Elkhader. Late Extensive Regional Recurrence of Paratesticular Dedifferentiated Liposarcoma 10 Years after Orchiectomy: A Case Report. Arch Cancer Sci Ther. 2026: doi: ; 10: 006-010
  • Adult Bladder Exstrophy with Premalignant Changes Following Failed Reconstruction: A Case Report
    Mohammed Amine Elafari*, Mamad Ayoub, Mohamed Amine Zaki, Mohammed Amine Bibat, Amine Slaoui, Tarik Karmouni, Abdelatif Koutani and Khalid Elkhader Mohammed Amine Elafari*,Mamad Ayoub,Mohamed Amine Zaki,Mohammed Amine Bibat,Amine Slaoui,Tarik Karmouni,Abdelatif Koutani,Khalid Elkhader. Adult Bladder Exstrophy with Premalignant Changes Following Failed Reconstruction: A Case Report. J Clin Med Exp Images. 2026: doi: ; 10: 020-023
  • Long monitoring of Birds of Elssuki Area. Sinnar State, Sudan
    Mohamed Elmekki Ali Elbadawi Hussien* Mohamed Elmekki Ali Elbadawi Hussien*. Long monitoring of Birds of Elssuki Area. Sinnar State, Sudan. Insights Vet Sci. 2024: doi: 10.29328/journal.ivs.1001040; 8: 001-011
  • Complications of External Otitis in Horses
    Schusser GF*, Kuhlmann CHR and Scheidemann W Schusser GF*, Kuhlmann CHR, Scheidemann W. Complications of External Otitis in Horses. Insights Vet Sci. 2024: doi: 10.29328/journal.ivs.1001041; 8: 012-014
  • Myiasis in a Backyard Pig: A Case Report
    Md Niamot Ali, Mahdi Hasan, Ireen Sultana Shanta, Md Abu Choudhury, Mustafizur Rahman and Abdulla Al Mamun Bhuyan* Md Niamot Ali, Mahdi Hasan, Ireen Sultana Shanta, Md Abu Choudhury, Mustafizur Rahman, Abdulla Al Mamun Bhuyan*. Myiasis in a Backyard Pig: A Case Report. Insights Vet Sci. 2024: doi: 10.29328/journal.ivs.1001042; 8: 015-017

Read More

Most Viewed

Read More

Help ?