The Turkish Journal of Pediatrics
2014 , Vol 56 , Num 1
Iliopsoas abscess in children: report on five patients with a literature review
1Division of Pediatric Infectious Diseases, 3Department of Pediatrics and 2Department of Radiology, Ondokuz Mayıs
University Faculty of Medicine, Samsun, Turkey. E-mail: drarzukarli@yahoo.com
We aimed in this study to present the clinical findings in children with iliopsoas
abscess (IPA) and to discuss the diagnosis and treatment. The files of five
patients, hospitalized between August 2011 and June 2013 and monitored with
a diagnosis of IPA, were reviewed retrospectively. Demographic characteristics,
symptoms and signs, laboratory examinations, and diagnostic and treatment
methods of the cases were evaluated. Two of the cases were females and three
were males, and their ages ranged from 10 to 15 years. Before the diagnosis,
the duration of symptoms in patients ranged from five days to one year.
The primary symptoms included fever and difficulty in walking. One patient
presented with septic shock and had a history of trauma as a predisposing
factor. All patients except one had a higher erythrocyte sedimentation rate
(ESR) and C-reactive protein (CRP) value. Psoas abscess was demonstrated
by ultrasonography (USG), except in one patient. Four patients underwent
percutaneous drainage of the abscess. The isolated microorganisms included
Staphylococcus aureus, Mycobacterium tuberculosis, and Enterococcus faecalis. All the
cases recovered without sequelae. Diagnosis of IPA in children is difficult,
and many physicians are usually consulted before any diagnosis is made. IPA
should be considered in the differential diagnosis in patients presenting with
complaints of lower back, hip, groin and leg pain and difficulty in walking.
Keywords :
psoas abscess, Pott’s disease, appendicitis, sepsis.