Delayed diagnosis and treatment of a psoas abscess as a link between spondylodiscitis and septic necrosis of the femoral head: a case report

Acta Biomed. 2020 May 30;91(4-S):241-247. doi: 10.23750/abm.v91i4-S.9627.

Abstract

Background: Infections of the spine and hip joint are not common and, as described in literature, they are occasionally linked by a psoas abscess. In patients suffering back pain with history of spondylodiscitis, the spine as primary source of infection for a secondary psoas abscess should always be included in differential diagnosis. A delay in diagnosis of the psoas abscess could lead to septic femoral head necrosis.

Case report: A case of a 65-year-old woman affected by septic femoral head necrosis due to spondylodiscitis and secondary psoas abscess is reported; the patient needed a specific antibiotic therapy then undergoing a total hip arthroplasty(THA).

Discussion and conclusion: Diagnoses of lumbar spine infection and psoas abscess are difficultand often delayed. Since the symptoms of both are non-specific, high degree of suspicious is necessary. In psoas abscess, an early diagnosis is important, because a delayed treatment could result in septic femoral head necrosis requiring both a prolonged antibiotic therapy and a THA.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Delayed Diagnosis*
  • Discitis / etiology*
  • Female
  • Femur Head Necrosis / etiology*
  • Humans
  • Lumbar Vertebrae*
  • Psoas Abscess / complications
  • Psoas Abscess / diagnosis*
  • Psoas Abscess / therapy*
  • Sepsis / etiology*
  • Time-to-Treatment*