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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References
- Psoas abscess - not as rare as we think?.Colorectal Dis. 2007; 9: 269-274https://doi.org/10.1111/j.1463-1318.2006.01135.x
- Psoas abscess: a 10 year review.J Microbiol Immunol Infect. 1999; 32: 40-46
- Pyogenic psoas abscess: analysis of 27 cases.J Microbiol Immunol Infect. 1999; 32: 261-268
- Hip flexion deformity secondary to acute pyogenic psoas abscess.Orthop Rev. 1987; 16: 67-77
Mückley T, Schütz T, Kirschner M, Potulski M, Hofmann G, Bühren V. Psoas abscess: the spine as a primary source of infection. Spine (Phila Pa 1976). 2003;28(6):E106-E113. doi: 10.1097/01.BRS.0000050402.11769.09
- Pyogenic psoas abscess: worldwide variations in etiology.World J Surg. 1986; 10: 834-843https://doi.org/10.1007/BF01655254
- Primary vs secondary iliopsoas abscess. Presentation, microbiology, and treatment.Arch Surg. 1995; 130: 1309-1313https://doi.org/10.1001/archsurg.1995.01430120063009
- Iliopsoas abscess due to nephrolithiasis and pyelonephritis.Clin Pract Cases Emerg Med. 2018; 2: 264-265https://doi.org/10.5811/cpcem.2018.4.38206
- Iliopsoas abscesses.Postgrad Med J. 2004; 80: 459-462https://doi.org/10.1136/pgmj.2003.017665
- Pyogenic psoas abscesses: noninvasive diagnostic techniques and review of the literature.Rev Infect Dis. 1983; 5: 1003-1011https://doi.org/10.1093/clinids/5.6.1003
- Xanthogranulamatous pyelonephritis with psoas abscess: 2 cases and review of the literature.Int Urol Nephrol. 2004; 36: 489-493https://doi.org/10.1007/s11255-004-0858-5
- Bilateral psoas and bilateral perinephric abscesses complicating acute pyelonephritis in pregnancy.Indian J Nephrol. 2013; 23: 59-62https://doi.org/10.4103/0971-4065.107213
- Psoas abscess rarely requires surgical intervention.Am J Surg. 2008; 196: 223-227https://doi.org/10.1016/j.amjsurg.2007.07.032
- Retroperitoneal schwannoma misdiagnosed as a psoas abscess: report of a case.Surg Today. 2002; 32: 849-852https://doi.org/10.1007/s005950200166
- Outcome of percutaneous continuous drainage of psoas abscess: a clinically guided technique.Indian J Orthop. 2014; 48: 67-73https://doi.org/10.4103/0019-5413.125506
Article Info
Publication History
Published online: March 31, 2022
Thomas J. Marrie, MD, Section EditorFootnotes
Funding: None.
Conflicts of Interest: None.
Authorship: All authors had access to the data and a role in writing this manuscript.
Identification
Copyright
Published by Elsevier Inc.
