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Vague abdominal complaints and low back pain are common in modern medicine. We describe the case of a patient who presented these symptoms twenty-one years after a nephrectomy accompanied by persistent elevated erythrocyte sedimentation rate for unknown reason. CT and fistulography showed a psoas abscess and a giant fistula.
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Intervertebral disc space infection in children is usually a benign, self-limiting process. We report on what is, to our knowledge, the first case of discitis in a child that developed into an anterior paraspinous abscess. This 13-year-old girl had a 3-month history of low back and leg pain and low grade fever. Roentgenograms of the spine showed collapse of the L-5, S-1 interspace with destruction of the L-5 vertebral body and, on the lateral lumbar view, an anterior soft tissue mass. Computed tomography showed a paraspinous mass to the right of the L-4 and L-5 vertebral bodies. Access to a right psoas abscess was gained through a retroperitoneal abdominal approach; draining of the abscess revealed necrotic disc material extruding from the L-5, S-1 interspace. Her recovery was uneventful. The causative organism proved to be Staphylococcus aureus.
Skeletal involvement is a relatively common complication of human brucellosis. Muscle infection and particularly psoas abcess is rarely reported and always secondary to spondylitis. We report here a case of brucellar abscesses in both psoas and right gluteal and posterior thigh muscles occurring without any skeletal, renal or bowel lesion.
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