The occult abscess

The clinical signs of an abscess may be masked by the patient's immunosuppressed state or antibiotic therapy. The authors reviewed the clinical presentations of 30 patients with 32 occult abscesses diagnosed with CT or US over 4 years. The abscesses included 12 intraperitoneal, 16 retroperitoneal, and four pleural infected fluid collections. Initial symptoms included fever of unknown origin in six patients and musculoskeletal complaints in four. Six patients were diagnosed with noninflammatory medical problems, five were under investigation for tumor, and, while an infectious process was suspected in nine patients, an associated abscess was not. The occult abscess may mimic other disease processes, and the radiological may be the first to suggest the diagnosis in patients in whom the classic signs and symptoms are absent