Primary psoas abscess--diagnostic and therapeutic considerations.

OBJECTIVE To present our experience of the diagnosis and treatment of primary psoas abscess in India. PATIENTS AND METHODS Between July 1993 and December 1995, five men (aged 24-67 years) presented with suspected primary psoas abscess. All five patients had fever with or without rigors and upper/lower abdominal pain of varying duration (2-6 weeks). RESULTS The presentation in all patients was conspicuous by the absence of the classical signs of limping and positive psoas symptoms. Computed tomography (CT) was the best method of diagnosis, being accurate in every case. Antibiotics alone (two patients), or in combination with percutaneous aspiration, were curative. CONCLUSIONS This small series of five patients of primary psoas abscess was remarkable in that all the patients were men and three were elderly. The classical symptom of limping was absent in all. The urologist can be misled by loin pain and irritative lower urinary symptoms in the patients, resulting in a delay in diagnosis and management.