PSOAS APSESİ

Psoas abscess (PA) is a rare
condition that presents diagnostic and therapeutic
challenges and PA has been more frequently
observed in recent years. The variable and nonspecific
presentations of PA, as well as its infrequent
incidence, can result in delayed diagnosis
and misdiagnosis.
Design.- Four cases diagnosed in our clinic are
presented analyzing the main clinical features,
microbiologic causal agents, risk factors and
treatment.
Results.- Four patients between the ages 17
and 67 years (mean: 45) were admitted to our
clinic between October 1998 and December
1999. The mean delay to consultation was 30
days. The main symptoms were fever, lumbar
pain. All patients were diagnosed by CAT. The
casual microorganisms were: S. aureus, E. coli
and Serratia marcescens. Three cases underwent
open surgical drainage and death in one
despite adequate medicosurgical treatment. One
patient was exclusively treated with antibiotics.
Conclusion.- PA is a serious health problem
which presents with non-specific symptoms and
signs. To reduce morbidity and mortality, it is important
to diagnose the presence and extent of
PA accurately using imaging studies. CAT is the
method of choice for the diagnosis. The correct
identification of the microorganisms, and the
prompt use of the antibiotherapy associated to
surgery, helped to a total recuperation of these
patients. In some cases a multidisciplinary approach
may be required.