Clinical Presentations, Diagnosis, and Treatments of a Psoas Abscess
Journal of the Korean Society of Emergency Medicine
; : 346-351, 2005.
Article
in Ko
| WPRIM
| ID: wpr-158541
Responsible library:
WPRO
ABSTRACT
PURPOSE: A psoas abscess is a rare, but life-threatening disease. We report 11 cases of a psoas abscess in adults and discuss its clinical presentations, diagnosis, and treatments. METHODS: Retrospective analysis of patients who presented to the emergency department with a psoas abscess from Jan. 2000 to Aug. 2004 was conducted. RESULTS: Of the 11 patients with a psoas abscess, 9 (81.8%) had a secondary psoas abscess. The most common causes of the secondary psoas abscess were various invasive procedures, such as acupuncture, a nerve block, etc. The main clinical presentations were fever (72.7%) and back pain (45.5%). The mean time to presentation was 12.0+/-10.6 days. All patients had leukocytosis and elevated CRP. Computed tomography (81.8%) and magnetic resonance imaging (18.2%) were performed for the diagnosis. The mean diagnostic lag time (from admission to the treatment) was 7.8+/-7.5 days. All patients received intravenous antibiotics. Four patients (36.4%) underwent surgical drainage, and three patients (27.3%) underwent percutaneous drainage. Two patients (18.2%) were treated with simple aspiration, and another two (18.2%) received no procedure. Six patients (54.5%) had complications. Three (27.3%) had a recurrent abscess, and two (18.2%) had a epidural abscess. In one patient, femoral neuropathy developed. The time from clinical presentation to diagnosis in the complication associated group was longer than it was in complication non-associated group (27.5+/-19.6 vs 10.6+/-3.2 days, p=0.03). CONCLUSION: A psoas abscess is difficult to diagnose because of vague clinical symptoms and can have serious complications if the diagnosis is missed or delayed.
Key words
Full text:
1
Index:
WPRIM
Main subject:
Magnetic Resonance Imaging
/
Drainage
/
Retrospective Studies
/
Psoas Abscess
/
Back Pain
/
Epidural Abscess
/
Femoral Neuropathy
/
Acupuncture
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Diagnosis
/
Abscess
Type of study:
Diagnostic_studies
/
Observational_studies
Limits:
Adult
/
Humans
Language:
Ko
Journal:
Journal of the Korean Society of Emergency Medicine
Year:
2005
Type:
Article