Insidious, no specific signs/symptoms so often delayed diagnosis. Pain in region of lower back or hip, fever. Often 10+ days later that becomes more obvious.
Usually caused by haematogenous spread, but may be due to local suppuration.
Blood tests are not very helpful! WCC/CRP/ESR non-specifically high. CK is rarely raised! Blood cultures often positive.
MRI is investigation of choice as ultrasound is only 60% sensitive.
Rx IV antibiotics for min 5/7 then complete 3-6/52 oral. Large abscesses will require surgical drainage (open or ultrasound guided). No reported sequelae but can be complicated by iliac thrombophlebitis followed by pulmonary emboli (akin to Lemierre’s disease).