Objective To present our experience of the diagnosis and treatment of
primary psoas abscess in India. Patients and methods Between July 1993
and December 1995, five men (aged 24-67 years) presented with suspect
ed primary psoas abscess. All five patients had fever with or without
rigors and upper/lower abdominal pain of varying duration (2-6 weeks).
Results The presentation in all patients was conspicuous by the absen
ce of the classical signs of limping and positive psoas symptoms, Comp
uted tomography (CT) was the best method of diagnosis, being accurate
in every case, Antibiotics alone (two patients), or in combination wit
h percutaneous aspiration, were curative, Conclusions This small serie
s of five patients of primary psoas abscess was remarkable in that all
the patients were men and three were elderly. The classical symptom o
f limping was absent in all. The urologist can be misled by loin pain
and irritative lower urinary symptoms in the patients, resulting in a
delay in diagnosis and management.