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General Medicine

Abscess, Psoas

Adriane E. Bell, MD, FAAFP Reviewed 06/2019
 


BASICS

Collection of purulent fluid in the iliopsoas compartment; high morbidity and mortality if not promptly diagnosed and treated 

DESCRIPTION

  • The iliopsoas compartment is a retroperitoneal anatomic ...

DIAGNOSIS

Diagnosis is often difficult. 

  • CT scan is the preferred imaging modality; definitive diagnosis is made through image-guided percutaneous drainage (PCD) and culture.

  • Definitive organism is isol...

TREATMENT

  • Most cases require PCD or open surgical drainage and parenteral antibiotics (16–20% success with antibiotics alone) (5)[B].

  • CT-guided PCD is initial procedure of choice (5)[B].

  • Open drainage i...

ONGOING CARE

Following drainage, pigtail catheter placement permits continued decompression of the abscess cavity and monitoring of purulent output. 

FOLLOW-UP RECOMMENDATIONS

Most patients require 3 to...

REFERENCES

1
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. [View Abstract on OvidMedline]
2
...

ADDITIONAL READING

Troelsen T, Hilberg O. Images in clinical medicine. Tuberculous abscess. N Engl J Med.  2014;371(2):161. [View Abstract on OvidMedline] 

CODES

ICD10

K68.12 Psoas muscle abscess 

ICD9

567.31 Psoas muscle abscess 

SNOMED

  • 266463007 Iliopsoas abscess (disorder)

  • 235997006 Abscess iliopsoas non-tuberculous (disorder)

CLINICAL PEARLS

  • Psoas abscesses are rare, retroperitoneal collections of pus resulting from hematogenous, lymphatic, or contiguous spread of infection.

  • Primary and secondary psoas abscesses have differ...

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Related Images
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FIG. 11 Diabetic patient with acute spontaneous onset of low back pain and fever. A,B: Dramatic elements of two-level spondylodiscitis, L3-5, with secondary communicating psoas abscess component.
FIG. 11 Diabetic patient with acute spontaneous onset of low back pain and fever. A,B: Dramatic elements of two-level spondylodiscitis, L3-...
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