Psoas Abscess as a Complication of a Perinephric Abscess

      A 61-year-old woman with hypertension, hyperlipidemia, bilateral nephrolithiasis in 2008 status postbilateral lithotripsy, and left-sided pyelonephritis in 2020 complicated by subsequent Guillain-Barré syndrome managed with intravenous immunoglobulin (IVIG) presented to the emergency department with subacute progressive right-sided abdominal and flank pain. Her symptoms began 4 weeks prior to evaluation when she felt a sharp pain in her right hip and right lower quadrant, which was exacerbated by movement of her right lower extremity.  She also endorsed cloudy urine. Two weeks prior, her right-sided pain became constant at rest. One week prior, she developed urinary frequency without dysuria. She denied fevers, chills, recent travel, recent sick contacts, or changes in bowel movements. She also denied recent abdominal trauma, recent surgeries, or instrumentation to the genitourinary area. Home medications included vitamin C, vitamin D, aspirin, lisinopril, hydrochlorothiazide, simvastatin, fluocinonide cream, melatonin, fluticasone, polyethylene glycol 3350 (ie, Miralax), and sennosides.
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