Pulmonary Tuberculosis With Nonspecific Psoas Abscess

Abstract

Psoas abscess is a rare disease in childhood. Usually its diagnosis is diffucult and so delayed. A five-year-old girl was admitted with high fever, sweating, swelling and pain on tight thigh and abdominal pain for one week. On family history there was no contact with any known tuberculosis case. She had two siblings who had died clue to diarrhea and pneumonia. At physical examination, the right leg was tender with movements and in flexion posture. There was also defence and rebaund on abdomen. Ultrasonography revealed a mass lesion at 39x17 mm diameters with heterogenous echo next to the psoas muscle. In laparotomy, the abcess has been drained and Staphylococcus aureus isolated in routine culture. Acid-fast staining and culture for mycobacterium was negative. Despite of appropriate antibiotic treatment, she had fever on the tenth hospital day so we presumed a tuberculosis infection. Serum adenozine deaminase level was high (45 IU/L) and thorax high resolution computed tomography demonstrated multiple changes consisted with pulmonary tuberculosis. Antituberculosis treatment was started. We conclude that psoas abcess was secondary to pulmonary tuberculosis. The patient has been well on follow-up after four months of treatment.