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Genito-pelvic actinomycosis is a rare condition that can be challenging to diagnose. It often occurs following long-term usage of Intra-Uterine Contraceptive Devices (IUCDs). The condition can be found at various anatomical levels but its presence in the psoas muscle is extremely rare. We report a case of a secondary psoas abscess which occurred in a 53 year old patient, three months after the removal of an IUCD that had been in situ for 8 years previously, and was associated with a severe infection. The initial management included drainage of the abscess and the upper urinary system followed by laparotomy. The time lapse between removal of the IUCD and onset of symptoms, lack of genitourinary infection and finally the delay of microbiological diagnosis contributed towards the difficulties in making this diagnosis.
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