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Medline ® Abstract for Reference 68

of 'Approach to acute abdominal pain in pregnant and postpartum women'

Primary iliopsoas abscess and pregnancy.
Nelson DB, Manders DB, Shivvers SA
Obstet Gynecol. 2010;116 Suppl 2:479.
BACKGROUND: Iliopsoas abscesses, a rare complication in pregnancy, typically present as a secondary infection due to direct spread of another nearby infection.
CASE: A 30-year-old multigravid patient with a 10-year history of intravenous heroin use and chronic lower-back pain, presented at 23 0/7 weeks of gestation with multiple cutaneous abscesses. As her back pain worsened during antepartum hospitalization, a primary iliopsoas abscess with underlying osteomyelitis was identified requiring percutaneous computed tomography-guided drainage along with extended-course intravenous antibiotics. After treatment and methadone detoxification, her pregnancy resulted in a successful vaginal delivery.
CONCLUSION: Primary iliopsoas abscess should be considered in the differential diagnosis of low-back pain among high-risk pregnant women. Clinicians should be vigilant in identifying high-risk factors and aggressive in treating this rare and potentially fatal complication.
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Parkland Health and Hospital System, Dallas, Texas, USA. dbnels@parknet.pmh.org