Primary fungal iliopsoas abscess caused by Candida albicans: a rare clinical entity

• Candida albicans is an extremely rare cause of iliopsoas abscess. • Diabetes predisposes to hematogenous fungal spread. • Fungal abscesses may initially mimic pyogenic infections. • Culture confirmation is essential, especially when empirical antibiotics fail. • Combined drainage and antifungal therapy lead to excellent outcomes. Fungal iliopsoas abscesses are exceedingly rare and typically occur in immunocompromised individuals. Candida albicans is an uncommon pathogen in this location and may lead to delayed diagnosis due to its nonspecific clinical features. Groin extension of such abscesses is even more unusual. We report a diabetic male patient with a large left iliopsoas abscess extending into the groin. Imaging showed a collection exceeding 10 cm. Initial empirical therapy included fluconazole. Combined surgical and percutaneous drainage was performed. Culture of the drained pus grew Candida albicans , confirming a fungal iliopsoas abscess. The clinical outcome was favorable. Fungal iliopsoas abscesses represent a rare subset of deep-seated fungal infections. Diabetes is an important predisposing factor. Diagnosis relies on imaging and microbiological confirmation. Candida albicans is seldom isolated from iliopsoas collections, making this case noteworthy. Optimal management includes drainage and targeted antifungal therapy. C. albicans iliopsoas abscesses are rare and should be suspected in diabetic or non-responding patients. Early identification and tailored antifungal therapy are essential for successful outcomes.