Bilateral Primary Psoas Abscess in Heat-stroke Patient: A case report

ABSTRACT

Psoas abscess is rare condition showing high mortality. Recently, we experienced a case of a bilateral primary psoas abscess in a severely ill heat-stroke patient. This is the first such report as par as we know. A 52-year-old man, construction crew member, was transferred to our hospital, presenting with a comatose mentality and high fever. Two hours before, he had collapsed on the work site, and the patient was diagnosed as having heat stroke with multiorgan failure and possibly aspiration pneumonia. However, the chest CT scan showed no specific abnormality, except swelling on the right psoas muscle. He was transferred to the ICU and underwent cooling. On the morning of the next day, the patient's rectal temperature was down to 37.1degrees C, and he woke up. On the third hospital day, the core temperature was elevated up to 38.4degrees C, and the patient became comatose again. On the 10th day, we performed an abdominal CT scan and found a bilateral psoas abscess. On the 13th day, MRI of the lumbar spine showed no other connection with adjacent organs and a decrease in the horizontal diameter of the abscess of 1 cm in comparison with that in a previous imaging. We continued to follow the medical therapy instead of surgical interventions, and follow-up abdominal CT scans showed complete resolution.