A Rare Case of Tuberculous Psoas Abscess in Pregnancy

Abstract

Psoas Abscess is a rare association with pregnancy. A 24 years old primi gravida with term pregnancy presented with PROM, oligo hydramnios, fever, tachycardia and inability to move both lower limbs. On examination, membranes were intact, there was bleeding PV with excess vaginal discharge. There was foetal tachycardia (180/min). To exclude abruptio ultrasound was done. Intra Uterine Death was diagnosed. That time patient was in early labour which was accelerated with syntocinon. Suddenly she became hypoxic and was ventilated. She delivered a stillborn baby. In the puerperial period patient suffered fever for more than a month. As fever was not controlled for long period (one month) CT was done which showed hypodense areas in right psoas muscle. CT guided Percutenous drainage was failed. By MRI investigation, it was diagnosed as multiple abscesses with sacro illitis and was drained extra peritoneally. As fever is not controlled with broad spectrum antibiotics, montox skin was done which was strongly positive. Hence treatment with anti tuberculosis drugs was planned. Finally fever was controlled by antituberculosis drugs ISONIAZID 300 mg/day, REFAMYCIN 600 mg/day, ETHAMBUTOL 800mg/day, Inj. STREPTOMYCIN 1 gm/day as a thereuptic trail.