PSOAS ILIAC MUSCLE ABSCESS

The experience with 14 patients affected of abscess of the psoas iliac muscle, attended at a general hospital through 1983-1995 is analized. This is a disease difficult to diagnose; it is usually diagnosed afte r a long delay (average of 45 days); it affects mainly women (rate F/M 11: 3), with a mean age in our patients of 50.4 years (14-79). The mo st frequent sign was fever (86% of the patients). Pain involving the t high was present in 57%, and the psoas' sign in 36%. Even when this si gn was present it did not always orient to the correct diagnosis. In t wo cases, the abscess was considered primary and in twelve it was asso ciated to osteomyelitis, urinary tract infection or tumor (cancer of c olon, metastasis in small bowell, melanoma and cancer of cervix). Gram smears and cultures of the material obtained by puncture were useful for detecting the causal germ, but blood cultures were inferior in yie lding it (1 positive in 8 cases). Gram positive germs were predominant (Staphylocccci coag. + in 4, Staph. coag. - in one, beta hemolytic St reptococci, 1). Gram negative germs were associated with urinary tract infections and staghorn lithiasis. In one case the etiology was TBC. Abdominal TAC was diagnostic when correlated with clinical data in 100 % of the cases; ecography was diagnostic in only 2 of 11 cases. Patien ts were treated with antibiotics and percutaneus drainage; the only de aths occurred in patients with cancer.