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

2022; BioMed Central; Volume: 16; Issue: 1 Linguagem: Inglês

10.1186/s13256-022-03417-4

1752-1947

Abdul Fattah Mohandes, Bahjat Karam, Ali Alrstom, Lugien Alasadi, Mohammad wahid Rajab Bek, Nizar Daher, Tamim Alsuliman, Raed Abouhareb,

Tuberculosis Research and Epidemiology

Primary psoas tuberculosis is the presence of "Koch's bacillus'' within the iliopsoas muscle caused by hematogenous or lymphatic seeding from a distant site. Muscular tuberculosis has relatively low prevalence in comparison with other cases of extrapulmonary tuberculosis, which explains the difficulties in establishing the diagnosis.In this report, we present a challenging diagnostic case of primary psoas tuberculosis in a 38-year-old middle eastern female from southern Syria. The diagnosis was based on the clinical orientation, the observation of pulmonary lesions on the computed tomography scan, and the necrotic signs in the vicinity of the infected area. Despite the misleading primary false-negative results, the final diagnosis was reached after sufficient repetition of tuberculosis-specific testing. The patient was treated with isoniazid-rifampin-pyrazinamide-ethambutol for 2 months, then isoniazid and rifampin for 7 months, with full recovery in follow-up.This case highlights the importance of a clinical-based approach in the treatment of patients with psoas abscesses, especially in areas with high tuberculosis prevalence.