A Case Report of Bilateral Pyogenic Psoas Abscess Caused by Shot Gun Injury of the Foot.

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Bilateral pyogenic psoas abscess is very rare although there are some reports of unilateral cases in recent years. This paper is described a case of bilateral pyogenic psoas abscess which we experienced recently.A 74-year-old man admitted for shot gun injury of the left foot on January 17, 1989. His wound was cured by 5-months treatment. Pus discharge from the left foot wound was found in 6-weeks follow up of outpatient clinic, and he was admitted again August 1, 1989. Remittent fever, low back pain and gait disturbance were observed with flexion contracture of the right hip on the second hospital day. Labolatory findings showed WBC count 21, 700/mm3, CRP (6+) and ESR 127mm/hr. Tomography of the lumbar spine revealed the enlarged psoas shadow and especially CT scan was available for diagnosis of the abscess cavity. Surgical treatment was performed through bilateral retroperitoneal approach to drain and curet the abscess. Bacteriological culture grew multiply antibiotic resistant Staphylococcus aureus. After surgery, he recovered dramatically from fever, low back pain and contracture of the hip and has been fine.