Pott's disease associated with psoas abscess: Case report

Abstract

Introduction Extrapulmonary tuberculosis may develop in any organ system, including the spine. The affection of spinal cord is called Pott's disease and it is the most frequent set. Pott's disease can present as back pain and be related to complications such psoas muscle abscess. Case presentation We report a case of 23-year-old Brazilian woman, natural from Amazonas, presenting with psoas abscess associated to Pott's disease treated with surgical debridement and drainage and extended tuberculosis scheme. Discussion Psoas abscess is rare and the main agents related to psoas abscess are Staphylococcus aureus , followed by Streptococcus and Escherichia coli . Retrofascial abscesses usually originate from bone lesions, including spine tuberculosis as our case, or due to contiguity of the retroperitoneal space. Conclusion Psoas abscess related to Pott's disease is a difficult diagnosis, requiring high suspicious and proper investigation through good anamnesis, CT scan and culture.

Psoas Abscess and Pott’s Disease Masked by Concomitant Invasive Staphylococcus aureus Disease: A Case of Misleading Diagnosis

“…Spine tuberculosis, also called Pott's disease, accounts for almost half of all cases of musculoskeletal tuberculosis [5]. Rarely, psoas abscess can be related to Pott's disease and it is a diagnostic challenge because of its indolent clinical course [5,6].…”

Mal de Pott associado à paraplegia: Relato de caso de tuberculose osteoarticular

“…No entanto, por ser um procedimento mais invasivo, com contraindicações relativas e absolutas e, também, indisponível em muitos serviços, o tratamento conservador acaba sendo preconizado. A paraplegia pode se recuperar em 40% dos pacientes com Mal de Pott apenas com a terapia medicamentosa através dos tuberculostáticos, que foi o caso da nossa paciente (Saint Clair et al, 2022).…”

“…A Tomografia Computadorizada (TC) e Ressonância Magnética (RNM) são exames preconizados e demonstram abscessos, invasões de tecidos moles na medula espinhal, com alterações inflamatórias significativas. A baciloscopia (com coloração pelo método de Ziehl-Neelsen), teste de reação em cadeia da polimerase (PCR) e cultura, por meio da biópsia das lesões geralmente possuem resultado negativo, o que dificulta o diagnóstico, que pode ser confundido com abscessos piogênicos, neoplasias ou sífilis terciária (Saint Clair et al, 2022;Chicué et al, 2021).…”

Psoas Abscess with Pott Spine: A Case Report

“…Upon admission, the drainage from psoas abscess site was performed using Pigtail catheter. Literatures suggest that the treatment of Potts spine and pulmonary tuberculosis is similar [4]. Antituberculous drug regimen included Isoniazid (300mg), Rifampicin (450mg), Ethambutol (800mg) and Pyrazinamide (750mg) with a frequency of (2-0-0).…”

“…A death rate of 5-15% and relapse rate of 15.8% have been reported with PA [3]. The psoas muscle arises from the transverse processes of the 12th thoracic vertebra and all of the lumbar vertebrae where lumbar, iliolumbar, obturator, external iliac, and common femoral arteries provide rich blood supply which puts the iliopsoas at risk for hematogenous infection spread [4]. Primary (isolated) Tuberculous Psoas Abscesses are frequently accompanied by Concurrent Spondylodiscitis (Pott's disease) [5].…”