A case of bilateral psoas abscesses in a patient with rheumatoid arthritis / 대한내과학회지

ABSTRACT

A psoas abscess is a rare clinical entity that presents diagnostic and therapeutic challenges. Tuberculous vertebral osteomyelitis was formerly the principal cause of a psoas abscess, but now psoas abscesses most commonly result from direct extension of intraabdominal infections. Occasionally, a psoas abscess results from extension of a perinephric abscess due to secondary infection of a retroperitoneal hematoma. Staphylococcus aureus is the most common cause of psoas abscess secondary to vertebral osteomyelitis. Tuberculosis, malnutrition, alcoholism, diabetes mellitus, rheumatoid arthritis and steroid use are responsible for compromise in host defenses and consequent increase in the relative risk of psoas abscess. Bilateral psoas abscesses are rare. A 66-year old woman with rheuamoid arthritis presented bilateral psoas abscesses. We report a case of bilateral psoas abscesses in rheumatoid arthritis confirmed by surgical drainage and tissue culture. To our knowledge, this is the second case report of bilateral psoas abscesses due to Staphylococcus aureus in a patient of rheumatoid arthritis in a world.