Diagnosis And Treatment Of Tuberculous Primary Psoas Abscess

Objective Tuberculous psoas abscess was usually associated to complicate Pott’sdisease, but it can also be secondary to direct extension from other adjacent structures orhaematogenous spread from an occult source. However, the occurrence of this entity asthe presenting manifestation of tuberculosis, without evidence of active infectionelsewhere, has been seldom reported. Method The medical records of13consecutivepatients presenting to our hospital in a10-year period with TPA were reviewed.Demographic data, presenting features, predisposing factors and the investigationsperformed were recorded. eleven cases were treated with Open drainage, one withUltrasound guided drainage, and the last case used antibiotics alone, mean Follow-up is2years and eventual outcomes were analysed. Results thirteen patients (five males)wereincluded. Ages between19-54years, mean40years.7cases on the left side,6cases on theright side.11cases all had lower backache or hip pain,2cases had fever, Only2patientspresented with the classical triad of pain, fever and limp. median hospital stay of12days,Follow-up showed no recurrence or death in patients. Conclusion The incidence of PA isprobably underreported. The vague presentation leads to delays in diagnosis and increasesmorbidity and a high index of suspicion is the key to early diagnosis. Open drainage hasLower recurrence and death rates, and used widely, is the most reliable method for thetreatment of primary tuberculous psoas abscess.