LATENT SOLITARY TUBERCULOUS PSOAS ABSCESS 52 YEARS AFTER HEALED THORACOLUMBAR TUBERCULOUS SPONDYLITIS

Study Design. This study reports on an extremely rare case of tubercul ous psoas abscess and describes the mode of diagnosis and treatment. O bjective. This patient is presented to emphasize that cases of solitar y psoas abscess resulting from tuberculosis exist today. Summary of Ba ckground Data. No recent cases of latent solitary tuberculous psoas ab scess have been reported, to the authors' knowledge. Methods. A tuberc ulous psoas abscess associated with fistula to the greater trochanter may remain dormant for years after tuberculous spondylitis has healed, as a distinct entity without concomitant active bone infection. In ou r 58-year-old female patient, the diagnosis of a psoas abscess was gre atly aided by the ''three pass'' technetium bone scan and computed tom ography, but the anamnesis also was important. Results. Anti-tuberculo sis medication (streptomycin, aminosalicylic, and isoniazid) combined with open drainage, curettage of the psoas, and simultaneous revision of the fistula eradicated the disease, making the course of the diseas e uneventful until the 5-year follow-up low-up evaluation. Conclusions . Orthopedic surgeons must be aware of the rare, delayed appearance of a solitary psoas abscess after tuberculous spondylitis.