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Chronic psoas abbcesses
From 4/5 years he's doing dressing on lower back at a whole continuously draining out pus . Daily that pus cells drain at it's own please tell me what's the solution
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Hello. A psoas abscess draining pus continuously for 4 to 5 years is a serious condition that indicates an unresolved underlying chronic infection (Chronic Psoas Abscess with Sinus Tract). Daily dressings only manage the pus discharge; they do not cure the primary cause.
Possible Medical Causes:
Spinal Tuberculosis (Pott's Disease): In India, long-standing chronic psoas abscesses with a draining sinus tract on the lower back are most frequently caused by underlying Tuberculous Spondylitis (TB of the spine/vertebrae).
Chronic Osteomyelitis / Bone Sequestrum: An untreated dead bone fragment or deep bone infection in the spine/pelvis can act as a continuous source of infection.
Atypical or Resistant Bacterial/Fungal Infection: Infections resistant to standard antibiotics or secondary to inflammatory conditions (such as Crohn's disease or deep retroperitoneal sinus formation).
Medical Approach:
Daily surface dressing is insufficient. A definitive diagnosis requires identifying the exact cause via imaging and pus analysis, followed by appropriate anti-tubercular therapy (ATT) or targeted long-term antimicrobials, often along with surgical management.
Next Steps
MRI of the Spine & Pelvis with Contrast: Crucial to visualize the extent of the psoas abscess, spinal involvement, and sinus tract path.
Pus Culture & GeneXpert / CBNAAT Test: Send fresh pus for Acid-Fast Bacilli (AFB) stain, GeneXpert (to confirm TB and rifampicin resistance), and Bacterial/Fungal Culture & Sensitivity.
Routine Blood Work: Complete Blood Count (CBC), ESR, and CRP to monitor inflammation levels.
Answered
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