PMC5743108_01
Initial CT-scan showing abscess with air-fluid level abutting left psoas muscle, indicated by red arrow.
ijgm-11-011Fig1.jpg
PMC5743108_01_ijgm-11-011Fig1.jpg
f1-ijgm-11-011
On the seventh hospital day, persistent abdominal pain prompted CT imaging of the abdomen, which revealed a 14x3.7x7.2 cm abscess along the medial wall of the left psoas muscle (Figure 1) and 2 additional abscesses at the L5-S1 level; 5.4x3.6 cm in the midline and 3.4x2.3 cm left of midline, and intramuscular air in the left gluteal muscles.
Repeat CT-scan showing abscesses in the left gluteal muscles, indicated by red arrows.
ijgm-11-011Fig2.jpg
PMC5743108_01_ijgm-11-011Fig2.jpg
f2-ijgm-11-011
We subsequently repeated a CT-scan on hospital day 24, which was consistent with multiple intramuscular abscesses in the gluteal muscles for which he underwent percutaneous drainage (Figure 2).
(A, B) CT-scan of left lower extremity, coronal sections showing abscess spanning the length of the vastus lateralis muscle. (C, D) Axial slices showing extent of abscesses. Red arrows indicate abscesses in vastus lateralis muscle.
ijgm-11-011Fig3.jpg
PMC5743108_01_ijgm-11-011Fig3.jpg
f3-ijgm-11-011
After deep venous thrombosis was ruled out, a CT scan was performed on hospital day 28, which showed a 10x20x3 cm intramuscular abscess in the vastus lateralis muscle, again treated with percutaneous drainage (Figure 3A-D).