Our data emphasize the importance of the
spine as primary source of infection and suggest an increase
in the incidence of secondary psoas abscess.
Treatment includes open surgical drainage and antibiotic
therapy. In patients with high operative risk and uniloculated
abscess, a CT-guided percutaneous abscess drainage
can be sufficient. It is essential to combine abscess
drainage with causative treatment of the primary infectious
focus. Related to the spine, this includes treatment
of spondylodiscitis or implant infection after spinal surgery.
Usually, several operations are necessary to eradicate
bone and soft-tissue infection and restore spinal stability.
Continuous antibiotic therapy over a period of 2–3
weeks after normalization of infectious parameters is
recommended.
Conclusion. The spine as primary source of infection
for secondary psoas abscess should always be included
in differential diagnosis. Because the prognosis of psoas
abscess can be improved by early diagnosis and prompt
onset of therapy, it needs to be considered in patients
with infection and back or hip pain or history of spinal
surgery.