2018 Research Forum

Tuberculous psoas muscle abscess and thoracic osteomyelitis case report Presenter & Principal Investigator: Natalie Peña-Brockett MS RA Faculty Sponsor: Adria Ottoboni MD

Adria Ottoboni MD 1 , Shannon Anderson MD 3 , Phillip Aguiñiga-Navarrete RA 2 , Natalie Peña-Brockett MS RA 2

1 Emergency Medicine Faculty; Health Sciences Associate Clinical Professor, David Geffen School of Medicine UCLA 2 Emergency Medicine Research Assistant Program 3 MD (Graduate, Kern Medical Emergency Medicine Residency Program) INTRODUCTION We present a case report of a patient who presented with right sided inguinal pain that was ultimately diagnosed with a tuberculous psoas muscle abscess concurrent with thoracic osteomyelitis. PURPOSE This case report describes the uncommon and interesting simultaneous combination of these two pathological entities, psoas muscle abscess and Pott’s disease (Image 1-2). The case is also instructive due to its delayed diagnosis of its causative organism, Mycobacterium tuberculosis. We also present the radiographic findings in the case and discuss the diagnostic difficulties associated with non-pulmonary Tuberculosis remains an important threat to public health, both worldwide and in the U.S. As such, it is important that emergency medicine practitioners remain vigilant regarding the diagnosis of mycobacterium tuberculosis regardless of its sometimes uncommon presentations. Psoas muscle abscess (PA) is a rare diagnosis, but even more uncommon in combination with Pott’s disease of the spine as a presentation of tuberculosis. Psoas muscle abscess is a rare disease that can be difficult to diagnose and has a myriad of inciting causes, including Crohn’s disease, appendicitis, septic arthritis, sacroiliitis, and diverticulitis. CONCLUSION Emergency medicine physicians should be aware of this condition so that they are appropriately educated regarding disposition and appropriate diagnostic modalities regarding tuberculosis and Pott’s disease. tuberculosis. DISCUSSION

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