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Psoas Abscess

 Syn. Psoas Abscesses , Psoas muscle abscess , Iliopsoas abscess

Signs & Symptoms

 Lower back pain
Ref: Uptodate [ Psoas abscess] Harrison [ 958]
Lower abdominal pain
Ref: Uptodate [ Psoas abscess] Harrison [ 958]
Psoas sign
Ref: Uptodate [ Psoas abscess] Harrison [ 958]
Flank pain
Ref: Uptodate [ Psoas abscess]

Physical Examination

 Psoas sign
Ref: Uptodate [ Psoas abscess] Harrison [ 958]
Subacute
Note: Few weeks up to six months
Ref: Uptodate [ Psoas abscess]
Inguinal mass
Note: Painless (tuberculosis more likely) or painful.
Ref: Uptodate [ Psoas abscess]

Lab / Serology

 Leukocytosis
Note: WBC > 10,000/mL
Ref: Uptodate [ Psoas abscess]
Elevated CRP
Ref: Uptodate [ Psoas abscess]
Elevated ESR
Ref: Uptodate [ Psoas abscess]

Imagin Study

 Abscess in the psoas muscle
Ref: Uptodate [ Psoas abscess]
Bony spinal infection
Note: Increase suspicion for tuberculosis.
Ref: Uptodate [ Psoas abscess]
Focal hypodense lesion in the psoas muscle
Ref: Uptodate [ Psoas abscess]

Complication

 Deep venous thrombosis
Ref: Uptodate [ Psoas abscess]
Paralytic bowel ileus
Ref: Uptodate [ Psoas abscess]
Vertebral osteomyelitis
Ref: Uptodate [ Psoas abscess] Harrison [ 958]

Risk Factors

 Age < 20
Ref: Uptodate [ Psoas abscess]
Male
Ref: Uptodate [ Psoas abscess]

Cause

 S. aureus
Ref: Uptodate [ Psoas abscess] Harrison [ 958]
Klebsiella pneumoniae
Note: Associated with concurrent urinary infection. Diabetes.
Ref: Uptodate [ Psoas abscess]
Xanthogranulomatous pyelonephritis
Ref: Uptodate [ Psoas abscess]

Other