PIRIFORMIS PYOMYOSITIS MIMICKING EPIDURAL ABSCESS IN A PARTURIENT

A case is presented of a patient who developed fever, leukocytosis sev ere back pain, local overlying spinal tenderness, and left leg weaknes s on the fifth day postpartum. The patient had epidural anaesthesia fo r ten hours duration, before and during a forceps delivery. Computeriz ed axial tomography (CT) and magnetic resonance imaging (MRI) of the p elvis and lumbar spine revealed swelling of the left iliacus and pirif ormis muscles, but no epidural abscess. A diagnosis of isolated pirifo rmis pyomyositis with secondary sciatic nerve irritation was made, and the patient was treated with intravenous antibiotics, nonsteroidal an ti-inflammatory agents, and morphine analgesia. She made a full, uneve ntful recovery within 50 days, and was discharged requiring no medicat ions.