![]() ![]() ![]() The CT scan showed multiple pockets of intramuscular abscesses in the belly of the adductor magnus muscle no iliopsoas abscess or any communication with the iliopsoas was noted ( Figs. Blood cultures were taken, the patient was resuscitated with fluids, a urinary catheter was inserted, the intensive treatment unit team was involved, and the patient was kept nil by mouth and was sent for an urgent computed tomography (CT) scan of the left hip/thigh and pelvis to confirm the diagnosis. The differential diagnoses were iliopsoas abscess with spread to the adductor muscles and necrotising fasciitis. On radiographs of the left thigh, soft tissue shadows were noted, and a complete blood count showed an elevated white cell count and a C-reactive protein (CRP) level of 625 mg/L. He had a background of multiple sclerosis and autoimmune skin conditions, and he was on long-term high-dose prednisolone. His body temperature was 38.9☌, he had hypotension, and he showed confusion with facial flushing. ![]() On examination, he had a palpable swelling over the medial aspect of the left proximal thigh and a skin induration over the lateral aspect. The patient reported nontraumatic, sudden-onset left thigh pain and swelling, with a reduced range of movement in the hip/knee and inability to bear weight. The clinical examination noted left thigh pain associated with reduced movement and left lower leg swelling. A 59-year-old male patient presented to the emergency department with sepsis in the evening. ![]()
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