[Abscess of the psoas muscle. Description of a series of 23 cases].

BACKGROUND: Abscess of the psoas muscle (PA) is an infrequent disease of difficult diagnosis. During the last decade, the number of cases has increased because of the raising use of radiology tecniques: ecography, computerized tomography and magnetic resonance nuclear.

METHODS: The presentation and management of psoas abscess was studied retrospectively in 23 patients from 1992 2000.

RESULTS: Sixteen of 23 abscesses were regarded as secundary: spondylodiscitis and pyelonefritis were most frequent pathologic processes. Homolateral pain in the flank area and hip were the usual manifestations. The duration of symptoms prior to the diagnosis was superior than 7 days. Staphylococcus aureus was the most common pathogen, followed by Escherichia coli and Mycobacterium tuberculosis. All abscesses were diagnosed by computerized tomography images. Seven patients underwent percutaneous drainage, while nine received surgical debridement. Four of the patients with psoas abscess died and only three relapsed.

CONCLUSIONS: Not specific symptoms and signs and subacute presentation difficult diagnosis of AP. High range antibiotics and drainage (percutaneous or surgical) should be considered as the election treatment.