A case report of bilateral psoas abscess with co-existing gluteal abscess in Pott`s disease of the spine in a middle-aged woman in a Specialist Hospital

Psoas abscess (PA) is the buildup of suppurative fluid in the fascia surrounding the psoas/iliopsosas muscle, is a rare condition, with diagnostic difficulty. Pott`s disease also called spinal tuberculosis occurs due to extra pulmonary tuberculosis. Backpain, fever, weight loss, lump in the groin and limping are its main symptoms. Curable by administering antitubercular therapy and sensitive antimicrobials with analgesics for indicative relief. Surgical procedures can be carried out to eliminate the accrued fluid based on the inter individual degree of presentation.

In this case report, we report a rare case of bilateral psoas abscess with co-existing gluteal abscess and Potts’s disease. A 48-year old female presented with complaints of backpain, limping, lump in the flank/buttock and fever of two weeks.

Abdominopelvic computed tomography scan showed massive right iliopsoas muscle collection with extension into the ipsilateral gluteal region and subcutaneous tissue. Similar collection was seen in the left psoas muscle superiorly. The bone window of the lumbosacral spine showed the anterior wedged collapse of the vertebral bodies with gibbus deformity. The patient had spontaneous rupture of the gluteal collection and surgical drainage of the right iliopsoas and left psoas collection was done. Anti-Kochs therapy was commenced and patient is currently doing great.

The introduction of computed tomography (CT) and magnetic resonance imaging (MRI) has greatly improved the diagnosis of psoas abscess with Pott`s disease or in its isolated forms.