Spontaneous Disappearance of Tuberculous Psoas Abscess Calcification

Case Details

Personal Characteristics

48-year-old woman, first presented at the age of 6

Clinical Characteristics

Back pain, radiographic features of spinal tuberculosis at t12/l1, bilateral calcified psoas abscesses, girdle pain due to further vertebral destruction at a higher level (t8-t12), small abscess cavity, large calcified psoas abscess on the right side and a small one on the left, symptoms due to the menopause

Remission Characteristics

Dramatic reduction in calcification at a time when the patient had not received any anti-tuberculous treatment for many years

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

Management was first by bed rest and later, at the age of 12, by postero-lateral drainage with spinal fusion, drained via a trans-thoracic approach, appropriate antibiotic cover was given for 2 years until 1975

Non-Clinical Treatment

Short course of hormone replacement therapy for menopause symptoms

Additional Notes

Calcified psoas abscesses are a characteristic feature of tuberculosis of the thoracolumbar spine. This case presents a unique instance of spontaneous disappearance of well-established calcification several years after any antituberculous treatment.