PT - JOURNAL ARTICLE AU - Caterina Froiio AU - Daniele Tiziano Bernardi AU - Emanuele Asti AU - Luigi Bonavina TI - Retroperitoneoscopic drainage of cryptogenic psoas abscess AID - 10.1136/bcr-2020-235579 DP - 2020 Jul 01 TA - BMJ Case Reports PG - e235579 VI - 13 IP - 7 4099 - http://casereports.bmj.com/content/13/7/e235579.short 4100 - http://casereports.bmj.com/content/13/7/e235579.full SO - BMJ Case Reports2020 Jul 01; 13 AB - Psoas abscess is a rare and occasionally life-threatening condition. In the past, the major cause of psoas abscess was a descending infection originating from spine tuberculosis (Pott’s disease). Subsequently, secondary infection from spondylodiscitis or Crohn’s disease has become the prevalent aetiology. Conventional treatment ranges from antibiotic therapy alone to CT-guided and/or surgical drainage. We present the case of a 67-year-old man with a complex history, including pneumonia, sepsis and previous muscle-skeletal trauma. The patient subsequently developed a psoas abscess that was successfully treated with a minimally invasive retroperitoneoscopic approach and antibiotics. Blood cultures and pus yielded Gram-positive Streptococcus sp, and transesophageal echocardiography identified endocarditis as a possible source of sepsis. Postoperative clinical course was complicated by recurrent sepsis that required a change of antibiotic therapy. The patient was eventually discharged to rehabilitation care without further complications. The retroperitoneoscopic approach is safe and effective for the treatment of cryptogenic psoas abscess.