Case Of Pyomyositis Research Articles

Infective Pyomyositis and Myositis in Children in the Era of Community‐Acquired, Methicillin‐ResistantStaphylococcus aureusInfection

Cases of pyomyositis and myositis have been increasing in frequency at Texas Children's Hospital (Houston) since 2000. The increase appears to correlate with the emergence of community-acquired methicillin-resistant Staphylococcus aureus (MRSA). The medical records of patients with pyomyositis and myositis hospitalized at Texas Children's Hospital during the period from January 2000 through December 2005 were reviewed. Available S. aureus isolates were obtained for susceptibility testing, to determine the presence of pvl (lukS-PV and lukF-PV), and for pulsed-field gel electrophoresis analysis. Forty-five previously healthy children with bacterial pyomyositis or myositis were analyzed. The causes were S. aureus (in 57.8% of children) and Streptococcus pyogenes (in 2.2%); 40.0% of children had negative culture results. The number of cases increased between 2000 and 2005, primarily as a result of an increase in the prevalence of community-acquired MRSA. The mean patient age was 5.5 years (range, 0.06-15 years). The thigh (40.0% of children) and pelvis (28.9%) were the most commonly affected sites. The mean abscess diameter was 3.5 cm. Eighteen children required at least 1 muscle drainage procedure. Of the 24 available S. aureus isolates (15 community-acquired MRSA isolates and 9 community-acquired, methicillin-susceptible S. aureus [MSSA] isolates), 16 were found to be USA300 by pulsed-field gel electrophoresis, and 17 carried pvl. Patients with community-acquired MRSA, USA300, and/or pvl-positive strains required more drainage procedures than did those with community-acquired MSSA, non-USA300, and/or pvl-negative strains (81% vs. 40% [P=.05], 82% vs. 29% [P=.02], and 81% vs. 38% [P=.07], respectively). Community-acquired MRSA is an increasing cause of pyomyositis and myositis in children. Community-acquired MRSA, USA300, pvl-positive S. aureus isolates caused more severe disease than did community-acquired MSSA, non-USA300, and pvl-negative isolates, respectively.

Streptococcal Pyomyositis of the Psoas

We present two unusual cases of pyomyositis of the psoas muscle caused by Group A beta-hemolytic streptococcus (GABHS) in children presenting with fever, emesis and leg pain. Pyomyositis secondary to GABHS is rare in children and cases involving the psoas muscle have not been previously reported. In our discussion, we review the epidemiology, presentation, diagnosis and treatment of GABHS psoas myositis in comparison with staphylococcal pyomyositis. Prompt recognition of the signs and symptoms of GABHS psoas pyomyositis is essential for treatment of this life-threatening infection.

A case of pyomyositis due to Mycobacterium tuberculosis

Pyomyositis is a primary bacterial infection of the skeletal muscles. Although infection can affect any skeletal muscle, the large muscle groups such as the quadriceps or gluteal muscles are most often the focus of this disease, and most commonly the inflammation is focal, involving a single muscle. The mechanism of pyomyositis is poorly understood. The local mechanical trauma at the time of an incidental bacteremia is frequently postulated as a mechanism that could explain the high incidence of the disease in tropical areas and its male preponderance. Staphylococcus aureus is the most common organism responsible for pyomyositis. Mycobacterium tuberculosis primarily affects the lungs, and the prevalence of active pulmonary tuberculosis co-existing with musculoskeletal tuberculosis has been about 30 percent. We report here on a case of an otherwise healthy 17-month-old girl, who had tuberculous pyomyositis at the upper arm after the hepatitis A vaccination with no evidence of any coexistent active tuberculosis

Salmonella Pyomyositisina Multiple Myeloma Patient: A Case Report

Pyomyositis is a bacterial infection of the skeletal muscle with Staphylococcus aureus being the most common pathogen. Pyomyositis by salmonella is quite rare accounting for less than 1% of the total pyomyositis, and has some different characteristics and a poor prognosis compared with those of the typical pyomyositis caused by other bacteria. Among these differences, an older age, other combined diseases, and an immune deficient condition are factors predisposing a patient to pyomyositis by salmonella. We experienced a very rare case of pyomyositis by salmonella at the inguinal area in a multiple myeloma patient. This is the first case reported in South Korea.

Die nicht-tropische Pyomyositis - ein seltenes Krankheitsbild in gemäßigten Klimazonen

Pyomyositis is in the moderate climate zone a rare and acute bacterial infection of the skeletal muscles without an obvious origin of infection. Initial symptoms contain muscle pain and localized swelling and tension. As different causes are taken into account first, the diagnosis of a pyomyositis is often delayed. We report on three cases of pyomyositis and discuss diagnosis and therapy against the background of the available and recent literature.

Pyomyositis of the quadratus femoris and gluteus minimus in two children

There has been an increase in the prevalence of pyomyositis in children living in temperate climates over recent years. Its presentation in the muscles surrounding the pelvis is similar to other diseases of the hip joint including septic arthritis and transient synovitis. This can lead to a delay in diagnosis and treatment. We present two cases of pyomyositis in children, at previously undescribed sites, highlight the importance of careful clinical examination and underline that MRI remains the gold standard for accurate diagnosis. Prompt treatment can prevent abscess formation and thus the need for surgical intervention.

Rapidly progressive pyomyositis of the elderly

We present a case of pyomyositis in an otherwise healthy 84-year-old Caucasian man. Massive thigh myonecrosis and abscess extending through the iliopsoas muscle into the retroperitoneum and thorax resulted in a fatal outcome. Though uncommon in temperate regions, this intermittently reported entity could elude early diagnosis with resulting grave sequelae particularly in the elderly. Our case highlights the aggressive nature of this rare diagnosis, need for use of MR Imaging earlier to quantify the disease, especially in the elderly with atypical presentation.

Pyomyositis of the piriformis muscle in a juvenile

The authors present a case of pyomyositis of the piriformis muscle. This case, the first in the English speaking literature of piriformis involvement in a juvenile, serves to illustrate the need for a high index of suspicion when treating children with symptoms related to impalpable pathology deep in the pelvis and the usefulness of MRI in early diagnosis and treatment before abscess formation. It also shows the potentially wide differential diagnosis in which the signs and symptoms may be misleading due to the close relationship of the pelvic muscles with the hip joint and adjacent viscera.

Physical signs in pyomyositis presenting as a painful hip in children: a case report and review of the literature.

The incidence of pyomyositis is on the increase worldwide among children and adults. When it involves muscles about the hip it needs to be differentiated from septic arthritis and transient synovitis among other diseases. Lack of awareness of the condition frequently leads to delay in correct diagnosis. We present one case of pyomyositis of the gluteus maximus and another rarer case of obturator internus pyomyositis that posed difficulties in initial diagnosis. While magnetic resonance imaging remains the imaging method of choice, we highlight important physical signs in the examination of patients presenting with a painful hip, which should raise suspicion of pyomyositis.

ひ腹筋内側頭に生じた化膿性筋炎の１例

Pyomyositis is a pyogenic infection of the skeletal muscle with or without obvious local or adjacent source of infection. The diagnosis of pyomyositis is often delayed because other primary diagnoses are first considered. This article discusses a case of pyomyositis of the medial head of the gastrocnemius muscle in a 73-year-old man who was not immunocompromised. A review of medical literature in also presented.

A Case of Pyomyositis of The Left Thigh in Type 2 Diabetes Mellitus Associated with Diabetic Ketoacidosis

A Case of Pyomyositis of The Left Thigh in Type 2 Diabetes Mellitus Associated with Diabetic Ketoacidosis

Multilocalized Pyomyositis in a Previously Healthy Subject

A case of pyomyositis is presented. This case is unique in the literature as at least 29 abscesses were detected, affecting the vast majority of big muscle groups. We outline the origin of this disease entity which selectively affects striated muscles. We also discuss its natural history and management strategy.

Pyomyositis in the Acquired Immunodeficiency Syndrome

Pyomyositis, a purulent infection of skeletal muscle, is usually caused by Staphylococcus aureus. Many cases of pyomyositis in human immunodeficiency virus (HIV) seronegative patients have been reported in North America and have been reviewed extensively. Moreover, pyomyositis has been reported in association with HIV infection in patients with or without the acquired immunodeficiency syndrome (AIDS). We describe two patients with pyomyositis and HIV and review the available English language literature. Leukocytosis and bacteremia tend to occur less frequently in those with HIV infection and pyomyositis. However, fever, S aureus infection, and bilateral involvement occur more frequently in HIV-positive patients. Antibiotic therapy together with surgical drainage or aspiration is usually sufficient.

Pyomyositis in the Acquired Immunodeficiency Syndrome

Pyomyositis, a purulent infection of skeletal muscle, is usually caused by Staphylococcus aureus. Many cases of pyomyositis in human immunodeficiency virus (HIV) seronegative patients have been reported in North America and have been reviewed extensively. Moreover, pyomyositis has been reported in association with HIV infection in patients with or without the acquired immunodeficiency syndrome (AIDS). We describe two patients with pyomyositis and HIV and review the available English language literature. Leukocytosis and bacteremia tend to occur less frequently in those with HIV infection and pyomyositis. However, fever, S aureus infection, and bilateral involvement occur more frequently in HIV-positive patients. Antibiotic therapy together with surgical drainage or aspiration is usually sufficient.

Three cases of pyomyositis in previously healthy adults

Three cases of pyomyositis in previously healthy adults

An uncommon spontaneous and nontropical pyomyositis

We describe a case of pyomyositis of the thigh caused by Staphylococcus epidermidis in an immunocompetent patient. The outcome was favorable after initiation of treatment combining surgical debridement of muscle abscesses and appropriate antibiotic therapy for a 4-week period. Our case report underlines that magnetic resonance imaging (MRI) may be a helpful method in the management of pyomyositis, in accurately revealing the detailed anatomic extent of the abscessed pyomyositis, and in guiding the surgical debridement of the damaged muscle. Finally, MRI should be performed if there is a strong suspicion of pyomyositis in patients whose ultrasonographic examination is not conclusive.

Pyomyositis in Babies Presenting with Painful Hip: Clinical and Radiographic Course of Two Cases

Two cases of pyomyositis in babies, one in the ilio-psoas muscle, the other in the quadriceps, are reported. The presenting sign was a painful hip in both, suggesting osteomyelitis of the proximal femur or arthritis. Pyomyositis is unusual in western countries and in healthy, well-nourished children, but these cases suggest considering this pathology in the differential diagnosis of a painful hip in babies. In the first case an upper respiratory tract infection was followed by haematogenous spread to the ilio-psoas muscle; in the second an injection of vaccine in the quadriceps played a determinant role. The latter case was complicated by secondary osteomyelitis; a metaphyseal radiolucent band just below the growth plate appeared in the early stage together with metaphyseal osteopenia and was interpreted as a consequence of altered blood flow in the metaphysis, not specific osteomyelitis, but indicative of some disturbance of the growth plate-metaphyseal complex.

Obturator Internus Pyomyositis

Pyomyositis appears to be increasing in prevalence in temperate climates, and often the orthopaedist is integral in the decision making and care of these patients. This is the first reported case of spontaneous bacterial pyomyositis involving the obturator internus muscle. Deep pelvic infections involving the psoas, iliacus, piriformis, and obturator internus can be a significant cause of morbidity and mortality. The infection subsequently may exit the pelvis, and conceivably may progress to a septic hip, bursitis, or lower extremity cellulitis. Improvements in noninvasive imaging such as ultrasound, computed tomography, and magnetic resonance imaging have produced finer resolution of tissue planes. Because of the pathology's deep location within the pelvis of the patient described here, all 3 tests were integral in the surgical planning, exposure, and proper diagnosis. Although 95% of pyomyositis cases are caused by Staphylococcus aureus, cases of pyomyositis with negative cultures have been described. Consideration should be made of disseminated Neisseria gonorrhoeae in sexually active individuals, and cultures should include Thayer-Martin agar to decrease the likelihood of a false-negative culture result.

Pyomyositis in an adolescent female athlete

A case of pyomyositis in a healthy 13-year-old female volleyball player is presented and discussed. This case is unusual because, historically, pyomyositis has been more common in males, especially those who participate in strenuous physical activity. However, competitive sports and vigorous exercise programs are becoming more widely available to young females. Therefore, a relative increase in the number of adolescent women with pyomyositis can be expected.

Nontropical pyomyositis in adults

Pyomyositis (PMS) is a primary infection of striated muscle. Recent scanty reports suggest that non-tropical PMS may differ from classical tropical PMS. To address this question, 12 cases of nontropical PMS seen at two hospitals between 1976 and 1992 were reviewed and an English-literature search of similar cases was conducted. Both the series and reported cases are pooled together and herein reported. The age distribution of the 97 patients showed 30–50 and 60–70-year peaks, with a 3:1 (male-female) ratio. Fever, high erythrocyte sedimentation rate, and muscle stiffness or inflammation were present in more than 75% of patients. Muscles of the thigh (54%), back (13%), buttock (11%), arm (9%), or chest wall (4%) were involved. Staphylococci (61%), gram-negative bacilli (16%), streptococci (12%), and fungi (2%) were isolated from muscle specimens. Human immunodeficiency virus infection, diabetes mellitus, hemopoietic disorders, and other conditions with defective neutrophil function were present in 64 patients (66%). Drainage of pus and antibiotic therapy were the standard treatments. The mortality rate reached 10%. Analysis of patients classified by the comorbid condition showed differences in age, causative microorganisms, clinical features, and death rate. It is concluded that several clinical presentations of nontropical PMS are at variance with that of tropical PMS.