Neurológia pre prax 3/2011

Primary psoas abscess

Acute lumbago, with a backache that radiates into the thigh, has a broad differential diagnosis. Rational diagnostic and therapeutic procedure often requires a rather broad medical knowledge. We present a case report of a healthy 27-year-old man, who was admitted to the neurology department with the low back pain and projection to the left thigh lasting for eight days. Higher temperature, increased CRP (C-reactive protein) and clinical findings led us to suspect abscess of the psoas muscle. The abdominal CT confirmed the suspicion of an abscess and subsequent biopsy under CT navigation and drainage of the abscess led to a correct diagnosis. Staphylococcus aureus was proven. Subsequent antibiotic therapy with a delayed definitive laparotomy of the primary abscess led to a rapid improvement.

Keywords: lumboischialgia, psoas abscess, navigated puncture of the abscess, Staphylococcus aureus, lesion of the femoral nerve.