Psoas abscesses are suppurative collections within the fascia surrounding the psoas and iliacus muscles. In this retrospective study it was aimed to evaluate the demographic characteristics, clinical and laboratory findings and treatment outcomes of 15
psoas abscess cases admitted to Baskent University Hospital, Ankara, Turkey during June 2003-January 2008 period. The mean age of the patients was 55.8 years (range 18 to 70 years) with a female to male ratio of 5/10. Thirteen of the cases (86.5%) were admitted with the complaints of
fever and
back pain. Thirteen of the cases were diagnosed by abdominal computerized tomography while the other two by abdominal ultrasonography. One of the 15 patients was considered as primary
psoas abscess, while the remaining 14 as secondary
psoas abscess. The most common accompanying disease was
diabetes mellitus (66.6%). Fourteen patients with secondary
psoas abscess had vertebral
osteomyelitis which was due to
tuberculosis in five cases, to
urinary tract infection in five cases, to pneumoniae in two cases, to surgical
infection in one case and to
brucellosis in one case. The cultivation of the
abscess material from the 14 secondary
psoas abscess cases revealed growth of bacteria in 11 of them (5 Mycobacterium tuberculosis, 1 Escherichia coli, 1
methicillin-sensitive Staphylococcus aureus, 1 methicilin-resistant S. aureus, 1 Acinetobacter baumannii, 1 Brucella melitensis, 1 Serratia marcescens). The biochemical parameters of the cases (mean leukocyte counts: 14.500 cell/mm3; mean erythrocyte sedimentation rates: 78 mm/hour; mean
C-reactive protein levels: 108 mg/dl) were also high. Thirteen patients underwent percutaneous drainage and received appropriate
antibiotic treatment and the other two patients were treated with open surgical
debridement. The duration of antimicrobial treatment was one year for M.
tuberculosis cases and about 4-6 weeks in the others. One of the cases died due to complicating
meningitis and
sepsis. It is remarkable that in our series none of the
psoas abscess cases were secondary to the diseases of the digestive tract unlike the series indicated in the literature. The isolation of M.
tuberculosis as the causative agent in 5 (33.3%) cases emphasizes the fact that
tuberculosis is still an important public health problem in Turkey.