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Life sciences · Review
International Journal of Drug Delivery Technology · October 8, 2026
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Background: Psoas abscess is an uncommon but potentially life-threatening infectious condition involving the iliopsoas compartment.The condition may occur as a primary infection through hematogenous spread or as a secondary process arising from contiguous extension of infection from adjacent structures.Individuals living with human immunodeficiency virus (HIV) are at increased risk of deep-seated infections because of immune dysregulation, opportunistic pathogens, delayed diagnosis, and coexisting comorbidities.Although psoas abscess is uncommon in the general population, it represents an important diagnostic consideration in HIV-infected individuals presenting with fever, constitutional symptoms, abdominal pain, or lower back pain.Objective: To provide a comprehensive narrative review of the epidemiology, pathogenesis, microbiology, clinical manifestations, diagnostic evaluation, and management of psoas abscess in patients living with HIV.Methods: A narrative review of published literature was performed using major biomedical databases.Relevant studies including observational studies, case series, case reports, reviews, and guideline documents addressing psoas abscess and HIV infection were evaluated.Particular emphasis was placed on epidemiology, microbial spectrum, diagnostic approaches, and therapeutic outcomes.Results: The available literature suggests that psoas abscess in HIV-positive individuals demonstrates considerable heterogeneity in etiology and clinical presentation.Staphylococcus aureus remains the predominant pathogen in pyogenic disease, while Mycobacterium tuberculosis constitutes an important cause in regions with high tuberculosis prevalence.Clinical manifestations are frequently nonspecific and may contribute to delayed diagnosis.Computed tomography and magnetic resonance imaging remain the cornerstone imaging modalities.Management requires prompt antimicrobial therapy combined with image-guided or surgical drainage when indicated.Conclusion: Psoas abscess should be considered in HIV-infected patients presenting with persistent fever, back pain, abdominal discomfort, gait disturbance, or unexplained constitutional symptoms.Early recognition, appropriate microbiological evaluation, and timely intervention are essential for reducing morbidity and mortality.Further studies are required to better characterize HIV-specific risk factors, optimal treatment strategies, and long-term outcomes.