Psoas abscess secondary to haematoma after a fall causing multiple osteoporotic fractures

Abstract

SummaryA 78-year-old woman presented 28 days after a low-impact fall, where she sustained a right pubic ramus fracture, with increasing left hip pain and fever. Her blood results showed a high white cell count and deranged urea and electrolytes. An MRI revealed multiple osteoporotic fractures and bilateral gluteal abscesses with left iliopsoas abscess, which had likely formed in a haematoma of a sacral fracture. She received a long course of intravenous antibiotics and CT-guided drainage of the abscesses. She developed symptoms of cauda equina, but no evidence of epidural extension of the abscess was found at operation. She required neurorehabilitation. This case highlights the complications of pelvic osteoporotic fractures, and high associated morbidity and mortality in the elderly population. BACKGROUND

Iliopsoas Abscess with Septic Arthritis of the Hip Following Trauma: Case Report

“…1,[4][5][6] Trauma to the iliopsoas muscle, resulting hematoma formation is also a significant risk factor for IPA. 7 Levin et al demonstrated pyomyositis development in injured muscle after administration of intravenous S. aureus. 8 However, iliopsoas hematoma following trauma is very uncommon.…”

Primary psoas tuberculosis abscess with an iliac bone lytic lesion: a case report

“…Iliopsoas abscess can be either primary (without a clear source of infection) or secondary (as a result of direct spread from neighboring structures, such as vertebral bodies and the gastrointestinal tract). The vast majority are caused by Staphylococcus aureus infections [ 2 , 3 ]. Rarely, Mycobacterium tuberculosis can cause a Iliopsoas abscess.…”