Pyogenic Psoas Abscess in a Patient With Chronic Low Back Pain: A Case Report

• Published in: Cureus Vol. 15; no. 12; p. e50330
• Main Authors: Almana, Ohoud, Ben Yahia, Khawla, Aldhabab, Adnan, Aljohani, Rawan, Bilal, Ahmad
• Format: Report
• Language: English
• Published: 01.12.2023
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.50330

A psoas abscess, a rare and clinically significant entity, poses diagnostic challenges due to its nonspecific presentation and diverse etiologies. This case report explores a compelling instance of a 58-year-old male with type 2 diabetes mellitus and chronic low back pain diagnosed with a large pyogenic psoas abscess. The patient presented with worsening right-sided lower back pain, fever, and chills. Clinical examination revealed lumbar tenderness and limited spinal mobility. Laboratory results indicated elevated inflammatory markers. Computed tomography identified a large abscess involving the right iliopsoas. A working diagnosis of pyogenic psoas abscess was established, prompting surgical intervention. This case emphasizes the diagnostic complexity of a psoas abscess, particularly in individuals with predisposing factors. Successful management, involving advanced imaging, targeted antibiotics, and minimally invasive interventions, underscores the efficacy of a multidisciplinary approach. Heightened clinical suspicion, prompt diagnosis, and tailored interventions are crucial for navigating the complexities of this condition successfully.