Tubercular abscess of the psoas without associated spinal involvement. A case report

Tuberculous psoas abscess outside of locoregional causes is uncommon and can cause a problem of differential diagnosis. We report a case of unilateral tuberculous abscess of the psoas which first clinical and radiological features presented like a retroperitoneal tumor. Exploration laparotomy discov...

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Bibliographic Details
Published in:La revue de medecine interne 2002-06, Vol.23 (6), p.549-553
Main Authors: Younes, M, Ben Ayèche, M Laziz, Béjia, I, Ben Hamida, R, Dahmène, J, Moula, T
Format: Article
Language:fre
Subjects:
Adult
Diagnosis, Differential
Drainage
Female
Humans
Psoas Abscess - diagnosis
Psoas Abscess - pathology
Psoas Abscess - therapy
Retroperitoneal Neoplasms - diagnosis
Tomography, X-Ray Computed
Tuberculosis - complications
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Summary:Tuberculous psoas abscess outside of locoregional causes is uncommon and can cause a problem of differential diagnosis. We report a case of unilateral tuberculous abscess of the psoas which first clinical and radiological features presented like a retroperitoneal tumor. Exploration laparotomy discovered a bulky abscess of the left psoas muscle. Bacteriologic and histologic evaluation confirmed the tuberculous origin. Radiological study of the spine did not show any signs of spondylodiscitis. Under antituberculosis treatment a crural collection occurred and a surgical drainage was performed. Five years later, there was a recurrence of a crural collection which responded well to antituberculosis treatment. Tuberculous psoas abscess is usually secondary to spinal involvement, more uncommonly to digestive, urologic or genital tuberculosis. Primary abscess was rarely described and the pathogenesis remains unclear. Psoas contamination is supposed to be hematogenous or lymphatic in origin. Ultrasonography and computed tomography (CT) transformed the diagnosis and the therapeutic approach by percutaneous puncture and drainage.
ISSN:0248-8663