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Published in: Forensic Science, Medicine and Pathology 3/2022

09-03-2022 | Autopsy | Case Report

A missed psoas abscess diagnosis: A forensic case report

Authors: Meriem Grayaa, Sami Ben Jomaa, Said Saadi, Seifeddine Ben Hammouda, Nouha Ben Abdeljelil, Dorra Oualha, Nidhal Haj Salem

Published in: Forensic Science, Medicine and Pathology | Issue 3/2022

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Abstract

Psoas abscess is a rare pathology that usually presents with non-specific signs and rare clinical features. These characteristics can delay the diagnosis leading to complications and death. We report a forensic autopsy case of a 65-year-old male, alcoholic, smoker, with a history of hypertension, and urinary infection, who presented to the emergency room for anorexia and consciousness disorder. On physical examination, the patient was febrile and confused. Laboratory exams revealed leukocytosis and elevated C-reactive protein (CRP). Two days later, he died despite extensive resuscitation. Forensic autopsy revealed a large amount of green pus in the left psoas muscle extending to the muscles of the thigh of the same side with multiple cavities. The pus extended to the left kidney with destructive parenchyma and coralliform lithiasis. Histological examination showed destroyed renal tissue by lesions of chronic and acute pyelonephritis with dilatation of the pyelocaliceal cavities. Bacteriological analysis of the pus showed the presence of Escherichia coli. The psoas abscess was secondary to pyonephrosis favored by the immunodeficiency. Thus, death was attributed to a septic shock secondary to a psoas abscess complicating pyonephrosis.
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Metadata
Title
A missed psoas abscess diagnosis: A forensic case report
Authors
Meriem Grayaa
Sami Ben Jomaa
Said Saadi
Seifeddine Ben Hammouda
Nouha Ben Abdeljelil
Dorra Oualha
Nidhal Haj Salem
Publication date
09-03-2022
Publisher
Springer US
Published in
Forensic Science, Medicine and Pathology / Issue 3/2022
Print ISSN: 1547-769X
Electronic ISSN: 1556-2891
DOI
https://doi.org/10.1007/s12024-022-00464-7

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