Moreira Barbosa Pedro Henrique, Martins Ezequias Batista, McBenedict Billy, Vargas Vilte Remberto Maurício de La Cruz, Oliveira de Moura Ronchini Karla Regina, Chilinque Zambão da Silva Natalia, Pinheiro Patrícia Yvonne Maciel, de Oliveira Vieira Thais, Villar Bianca Balzano de la Fuente
Hospital Universitário Antônio Pedro, Departamento de Infectologia, Niterói, Rio de Janeiro, Brazil.
Universidade Federal Fluminense, Faculdade de Medicina, Niterói, Rio de Janeiro, Brazil.
Rev Inst Med Trop Sao Paulo. 2025 Apr 14;67:e25. doi: 10.1590/S1678-9946202567025. eCollection 2025.
Psoas muscle abscess is an insidious disease, with varied clinical manifestations and a challenging diagnosis. This pathology has been more frequently identified due to the increased availability of high-quality radiological imaging, such as computed tomography. In Brazil, Mycobacterium tuberculosis is the most common secondary etiologic agent of psoas abscess. We report the case of a 28-year-old immunocompetent man diagnosed with disseminated tuberculosis, affecting the lungs, lumbar spine, and psoas muscle, leading to permanent locomotion sequelae. This case is very relevant for osteoarticular complaints, as low back pain and limping were the initial symptoms. Diagnosis was confirmed by ultrasound-guided percutaneous drainage of the psoas muscle abscess and detection of the M. tuberculosis complex via Xpert MTB/RIF. A 12-month treatment with antitubercular drugs was effective.
腰大肌脓肿是一种隐匿性疾病，临床表现多样，诊断具有挑战性。由于高质量放射影像学检查（如计算机断层扫描）的可及性增加，这种病理情况已被更频繁地发现。在巴西，结核分枝杆菌是腰大肌脓肿最常见的继发性病因。我们报告了一例28岁免疫功能正常的男性病例，该患者被诊断为播散性结核病，累及肺部、腰椎和腰大肌，导致永久性运动后遗症。该病例对于骨关节炎主诉非常重要，因为腰痛和跛行是最初的症状。通过超声引导下经皮穿刺引流腰大肌脓肿并通过Xpert MTB/RIF检测结核分枝杆菌复合体确诊。使用抗结核药物进行12个月的治疗有效。
