A rare cause of lower abdominal and pelvic mass, primary tuberculous psoas abscess: a case report

Abstract

IntroductionTuberculous psoas abscess was usually associated to complicate Pott's disease, but it can also be secondary to direct extension from other adjacent structures or haematogenous spread from an occult source. However, the occurrence of this entity as the presenting manifestation of tuberculosis, without evidence of active infection elsewhere, has been seldom reported.Case PresentationWe report a clinical case of a 64-year-old immunocompetent female that presented with left lower abdominal pain and a soft tissue mass over the left iliac fossa and inguinal regions due to a primary tuberculous psoas abscess. Early diagnosis and prompt treatment with percutaneous drainage guided by ultrasound along with antituberculous drugs, lead to a satisfactory outcome.ConclusionThe purpose of this case report is to point out attention to the diagnostic challenge of tuberculous psoas abscess in the absence of tuberculosis in other organs or a predisposing condition. A brief review of the literature about its epidemiology, etiology, clinical features and management is discussed over the text.

Abdomen agudo ocasionado por apendicitis aguda de probable origen tuberculoso. Informe de un caso

“…Actualmente hay en el mundo cerca de 10 millones de casos nuevos por año y unos dos mil millones de individuos con infección latente. Entre los factores responsables de este aumento está la infección por el virus de inmunodeficiencia humana (VIH) sobre todo en países subdesarrollados como los de África subsahariana (3); en los países con rápido crecimiento económico se asocia con la diabetes mellitus (3); por otra parte, la alta migración entre países es una fuente importante de transmisión de enfermedades infectocontagiosas como la infección por TB, VIH y otras (1,4). En Mé-xico, una causa puede ser la migración continua a Estados Unidos de Norteamérica.…”

“…La TB afecta principalmente las vías aéreas inferiores y con menor frecuencia los sistemas nervioso central, linfático, óseo y articular y la piel (4,10). Se transmite por contacto directo y se disemina por vía linfohematógena, por lo que el bacilo puede llegar a cualquier sitio del cuerpo incluyendo el tubo digestivo y el apéndice cecal.…”

“…Esto ha hecho que muchos países estén uniendo sus esfuerzos para lograr su control adecuado (1,3,4). Las formas extrapulmonares constituyen el 10 % de los casos y la tuberculosis del tubo digestivo es responsable del 0,1 al 1 % de dichas formas.…”

Two Cases of Childhood Renal and Retroperitoneal Tuberculosis Presenting with Psoas Abscess

“…Psoas apselerinde tanı için genellikle invazif olmaması ve kolay uygulanabilirliği nedeniyle ultrasonografi (USG) yeterli olmakla beraber, gecikmiş ve yaygın olgularda boyutların tam ve net olarak değerlendirilebilmesi için batın bilgisayarlı tomografisi (BT) ile de görün-tüleme gerekmektedir (2,14) . Tanı aşamasında her iki olgumuzda da ilk tercihimiz USG olmasına ve tanı için yeterli olmasına rağmen, lezyonların boyutlarının ve çevreye yayılımlarının netleşti-rilmesi açısından iki olgumuzda da batın BT çekilmesi gerekti.…”

Management of abdominal and pelvic abscess in Crohn’s disease

“…Also, in choosing the correct antibiotic, it is helpful to know the organisms' resistance pattern in the community and local hospital setting [9,21] . Patients from underdeveloped countries or those who are immune suppressed might have tuberculosis or other opportunistic infections as the causal organism [22] . Abscesses less than 3 cm do not require drainage.…”