Psoas abscess
ICD-10 K68.1 · ICD-11 FB30&XA43E9&XA7DA1

Treatment of Secondary Iliopsoas Abscess When an Underlying Disease Is Present

Clinical Scenario

This protocol addresses secondary iliopsoas abscess — the form defined by the presence of an underlying disease. Secondary iliopsoas abscess is distinguished from primary iliopsoas abscess precisely by the identification of an underlying disease process. Recognition of this distinction shapes the treatment strategy applied.

Treatment Approach

The approach involves drainage of the abscess together with broad-spectrum antibiotic therapy. The specific drainage method and the full antibiotic strategy depend on individual clinical factors.

The complete regimen — including drainage approach selection, decision criteria, and the full antibiotic strategy — is available in the structured protocol below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1136/pgmj.2003.017665

Iliopsoas abscess may be classified as primary or secondary, depending on the presence or absence of underlying disease.

In secondary iliopsoas abscess it is wise to start patients on broad spectrum antibiotics like clindamycin, antistaphylococcal penicillin, and an aminoglycoside.

Drainage of the abscess may be done through computed tomography guided percutaneous drainage (PCD) or surgical drainage.

The indications of operation are (a) failure of PCD, (b) relative contraindication of PCD, for example, clotting disorders, and (c) the presence of an another intra-abdominal pathology which requires surgery.

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