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Primary Psoas Abscess Complicating a Normal Vaginal Delivery

Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut; and Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania

Address reprint requests to: Paolo F. Rinaudo, MD, University of Pennsylvania, Department of Obstetrics and Gynecology, 3400 Spruce Street, 106 Dulles Building, Philadelphia, PA 19104; E-mail: prinaudo{at}obgyn.upenn.edu.

ABSTRACT

BACKGROUND: Psoas abscess is a rare and potentially dangerous complication of normal delivery.

CASE: We describe a case of primary psoas abscess after normal vaginal delivery. A young woman presented with fever, left back pain, left lower abdominal pain, and hip pain starting on postpartum day 2. Computed tomography demonstrated a large retroperitoneal collection. Aspiration drainage of the abscess under computed tomography guidance isolated Streptococcus viridans, which responded to antibiotic therapy and percutaneous drainage with complete resolution.

CONCLUSION: A high index of suspicion is necessary for diagnosis of psoas abscess, which should be considered in postpartum patients with pyrexia, back and hip pain, and a normal neurologic examination. Computed tomography is effective for diagnosis and allows percutaneous drainage of the abscess.

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