Psoas abscess and acupuncture

Psoas abscess is a rare condition, and is classified as either primary (haematogenous spread from a distant infection) or secondary (local spread from an infective process). In the past, secondary cases resulting from spinal tuberculosis (TB) were the most common,1 but this has changed with the fall in prevalence of TB in many parts of the world. Now the most common causes of secondary cases in the developed world appear to be inflammatory or neoplastic diseases of the bowel, kidney and spine, such as Crohn’s disease, diverticulitis and carcinoma.23 Primary psoas abscess most commonly occurs in children and the causative organism is most often Staphylococcus aureus.14 When primary psoas abscess occurs in adults it may be associated with chronic disease, general debility or specific impairment of immune function.25

In the linked case report in this issue (page 81), “Polyarticular septic arthritis with bilateral psoas abscesses following acupuncture – a case report”, Ogasawara and colleagues report a previously healthy patient who developed polyarticular …