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

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