Retrofascial Bilateral Psoas Abscess in a 6-Year-Old Child

Abstract not available. Introduction provided instead.

Retrofascial abscess of the psoas muscle was first described by Herman and Mynter in 1881 and is considered a rare disease.^1-5 Possible etiologies for the primary form of the disease are trauma, skin infection, lymph node suppuration, and nutritional and socioeconomic factors; the secondary form results mainly from Crohn’s disease or tuberculosis.^1,2,6-8

Classic features of the disease are a triad of insidious installation of flank pain, limping, and flexion contracture of the ipsilateral hip, normally accompanied by consumptive signs and symptoms.^1,2,6,9,10 Among the differential diagnoses are hip and sacroiliac septic arthritis, lymphadenitis, lymphoma, pelvic inflammatory disease, osteomyelitis of the spine, sarcoma on the thigh,¹ psoas and retroperitoneal tumors,^11,12 hematoma of the psoas,¹³ and avascular necrosis of the hip.

Ultrasonography and computed tomography (CT) are the main, complementary examinations used to diagnose the disease.^1,4,6,14-18 Treatment consists of percutaneous puncture or open drainage, followed by appropriate antibiotic therapy.^1,6,9,12,19

Prognosis is good, even though mortality rates are 2.5% for the primary form, 20% for the secondary form, and up to 100% in cases of late diagnosis and inadequate treatment.^3,4,8,20

In this article, we present the case of a 6-year-old boy with bilateral psoitis. Psoitis affects both muscles simultaneously in less than 1% of cases; approximately 500 cases have been reported worldwide.^8,21