Paraspinal abscesses in a diabetic patient

Paraspinal and iliopsoas abscesses are rare conditions that are often diagnosed late therefore it can cause significant morbidity and mortality. They can occur in the setting of intravenous drug abuse, diabetes, crohn's disease and human immunodeficiency virus (HIV). We report a 52 year old diabetic male with history of hepatitis C, polysubstance abuse who presented to the hospital complaining of severe back pain as well as vague abdominal pain. Patient underwent an urgent magnetic resonance imaging (MRI) that confirmed presence of paraspinal and iliopsoas abscesses. The patient once diagnosed underwent cat (CT) scan to rule out osteomyelitis. He also underwent CT guided biopsy and aspiration via 18 gauge spinal needle followed by placement of 10 French pigtail draining catheter. Patient responded well to the hospital treatment and his condition improved steadily over a week. Pathogenesis, diagnosis and therapy of iliopsoas as well as paraspinal abscesses are reviewed for this unusual condition.