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At least 199 records · Page 11Linked to original sources
PubMed1996

Tropical pyomyositis.

Tropical pyomyositis (TP), a suppurative disease caused predominantly by Staphylococcus aureus, is responsible for 3% to 4% of surgical admissions in some hospitals in certain tropical countries. This study describes the clinical features of 35 patients with TP (20 males, 15 females; mean +/- SD age 28.3 +/- 14.1 years) admitted to our hospital during a 1-year period and analyzes the causal association between ancylostomiasis, human immunodeficiency virus (HIV) infection, and TP. Concerning the supposed etiologic association between Ancylostoma duodenale infection and TP, among the 35 patients with TP the stool examination of 22 (62.8%) revealed the presence of eggs of A. duodenale. In a control group of 100 asymptomatic subjects the prevalence of ancylostomiasis was 55%. The Odds ration between the two groups is 1.38 (exact 95% confidence limits = 0.59 < OR < 3.34). Furthermore, the pus from all TP abscesses (41 in 35 patients) was carefully collected and examined microscopically, but nematode larvae were not detected in any of the specimens. Hence these results do not support an association between ancylostomiasis and TP. With the aim of correlating TP with HIV infection, I carried out a case-control comparison of HIV seroprevalence among the patients affected by TP and an age- and sex-matched control group of healthy subjects. Eleven patients with TP were HIV antibody-positive (seroprevalence 31.42%), as were two controls (seroprevalence 5.71%). The matched analysis produced a Mantel-Haenszel matched Odds ratio of 5.50 and a maximum likelihood estimate of OR (MLE) of 5.50 (exact 95% confidence limits for MLE: 1.20 < OR < 51.07). Among the 11 patients HIV-seropositive, 9 (81.8%) fulfilled the World Health Organization clinical case definition (CCD) for AIDS, compared with 1 of 24 (4.1%) HIV-negative subjects. The chi-square test for difference in fulfilling the CCD for AIDS between patients with TP seropositive and seronegative result was statistically significant (p < 0.0001). It is concluded that TP is a bacterial infection highly significantly associated with HIV infection and thus must be considered a strong sign of stage III-IV of HIV disease.

Adolescent↗
PubMed2002

Pyomyositis associated with bacillary angiomatosis in a patient with HIV infection.

Bacillary angiomatosis is an opportunistic infection occurring predominantly in patients with HIV infection. The manifestations of this vasculoproliferative disorder vary markedly. Virtually any organ site may be involved, singly or multiply. However cutaneous involvement can be a valuable clue to its diagnosis. We report a case of bacillary angiomatosis in an HIV-infected patient presenting as isolated pyomyositis of the right leg. The rarity of such a presentation and paucity of cutaneous lesions, as in our case, may render timely diagnosis elusive and difficult. Its recognition however, is important since bacillary angiomatosis, if untreated, is potentially fatal.

AIDS-Related Opportunistic Infections↗
PubMed1979

Pyomyositis. Review of 205 cases in 112 patients.

A study of pyomyositis, a pyogenic infection of the muscle, in 112 patients is presented. The etiologic role of suggested factors remains unclear. Early recognition and aggressive management with antibiotics, incision, and drainage usually lead to rapid resolution. Accordingly, the clinical findings are presented, and criteria for diagnosis are suggested.

Adolescent↗
PubMedDate not supplied

Tropical pyomyositis in the Solomon Islands: clinical and aetiological features.

A prospective study of tropical pyomyositis (TP) in the Solomon Islands' Western Province followed 48 cases (mean age 10.6 years) from a population of 20,000 Melanesians over a two-year period. 32 patients were under 10 years and the male:female ratio was 1.7. Affected muscle was painful, swollen and often fluctuant but hard and indurated in presuppurative lesions. Abscesses, single in 40 and multiple in 8 subjects, were sited in the large muscles of the buttock, thigh, shoulder, arm and back on 52 occasions (90%). They contained 5-200 ml of pus which invariably grew penicillin-resistant Staphylococcus aureus sensitive to cloxacillin and erythromycin. All phage typable strains were identified as group 2 in contrast to the wider range of types found at carrier sites in otherwise healthy controls. TP was preceded by trauma in 30 cases (63%) and 26 (55%) of the patients had pre-existing pyoderma. Histological examination of clinically unaffected muscle biopsies from 10 subjects with solitary (7) or multiple (3) abscesses showed no abnormality. Serological evidence of previous infection with adenoviruses or myxoviruses was present in the same proportion (41-42%) of controls as of 22 patients tested. The results provide no evidence for antecedent diffuse myositis, viral or parasitic infections or nutritional deficiencies but support the role of trauma in localizing haematogenous skin staphylococci into damaged muscle.

Child↗
PubMedDate not supplied

Tropical pyomyositis associated with Trypanosoma brucei rhodesiense infection in a Europid.

A 29-year-old European woman became infected with Trypanosoma brucei rhodesiense in the Luangwa valley, Zambia. Six days after the initial presentation of this infection she developed evidence of tropical pyomyositis (TP). These diseases, both of which are rare in Europids, were satisfactorily treated. The pathogenesis of TP, which is nearly always caused by Staphylococcus aureus, is undetermined. It seems possible that in this case either (i) both infections were introduced simultaneously by a tsetse-fly bite, or (ii) T. b. rhodesiense produced multiple focal necroses in skeletal muscles which acted as niduses for the staphylococcal infections; immunodepression caused by this parasite might also have been important.

Adult↗
PubMed1994

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.

Adult↗
PubMed1996

Tropical pyomyositis in a temperate climate: a case report.

Pyomyositis is an abscess-forming infection of large skeletal muscles, usually with Staphylococcus aureus. Although it is common in the tropics and relatively rare in temperate climates, imported cases due to growing global mobility may be expected to increase its incidence outside tropical regions. Early diagnosis and correct management are imperative in this potentially fatal disorder, and require a high degree of clinical suspicion. A case report is presented demonstrating typical aspects of diagnosis and treatment.

Abscess↗
PubMed1981

Tropical pyomyositis, a thiamine-deficiency disease.

On the basis of clinical observations made in Shanghai which confirmed the clinical and experimental findings of Osawa in Japan, it is suggested that thiamine deficiency is an essential contributary factor in producing tropical pyomyositis (TPM). It was found that the majority of patients affected by TPM suffer or have previously suffered from beriberi. The practical disappearance of TPM in Japan in recent years supports the above view. Thiamine deficiency induces a biochemical lesion (Peters) in the pyruvate oxidase system of the muscle, which breaks down its normal resistance to infection and opens the gate to bacterial agents. It is possible that in different parts of the world other or additional factors may play a similar role to that of thiamine deficiency. It is suggested that a wide survey should be undertaken--perhaps by the World Health Organisation--especially in areas in which TPM is endemic, using all relevant methods, to elucidate the factor or factors responsible for the development of TPM.

Adult↗
PubMed1991

Pyomyositis: early detection utilizing multiple imaging modalities.

Pyomyositis represents 3% to 4% of surgical admissions in East Africa, however, there were no reported cases in the United States prior to 1971. Since, there have been numerous reports of this entity. Four recent cases are presented utilizing multiple imaging modalities including magnetic resonance. MR was very sensitive to early soft tissue inflammatory processes and demonstrated these focal abscesses with superior anatomic localization. MR is advocated in the initial evaluation of a focal process. In a systemic, nonfocal process, nuclear medicine WBC or Gallium Scans to localize areas for further MR scanning is recommended.

Abdominal Muscles↗
PubMed1992

Tuberculous pyomyositis in a renal transplant recipient.

Infections are a major cause of morbidity and mortality in renal transplant recipients. Although these patients are susceptible to many types of infection, soft tissue infections are rare. We report a case of tuberculous pyomyositis involving the left erector spinae muscle but with no other manifestations of tuberculosis. The diagnosis was suspected from the CT scan appearance and confirmed by microscopy and culture of the pus. Surgical incision and drainage, together with antituberculosis therapy, cured the infection. The relevant literature is briefly reviewed.

Adult↗
PubMed2004

Pyomyositis.

Four patients were admitted to Columbia Presbyterian Medical Center for evaluation of lower extremity pain and swelling. Three patients were initially misdiagnosed with cellulitis and one patient underwent evaluation for dermatomyositis. After consultation by the dermatologist, a correct diagnosis of pyomyositis was made clinically and confirmed by imaging, surgery, or an interventional procedure. Wound, blood, and urine cultures were positive for methicillin-sensitive Staphylococcus aureus in 100%, 50%, and 25% of patients, respectively. After the appropriate diagnosis and treatment, all patients experienced rapid resolution of symptoms and a favorable outcome.

Adult↗
PubMed2004

Bacterial pyomyositis: MRI and clinical correlation.

OBJECTIVE: To characterize the findings of magnetic resonance imaging (MRI) of bacterial pyomyositis (PM) and correlate these data with the clinical information. MATERIALS AND METHODS: Eighty-one patients were diagnosed with PM in our institute between 1997 and 2003. Of these, 40 patients (21 male, 19 female; mean age, 53 years) also underwent MRI examination. The clinical manifestation underlying medical problems and the characteristics of MRI were analyzed. Thirty of the patients received surgical intervention or image-guided drainage/aspiration of the abscess along with administration of antibiotics, while the remaining 10 patients were promptly treated solely with antibiotics. RESULTS: Thirty-one of 40 patients had underlying medical problems. These involved diabetes mellitus (DM, n = 16), malignancies including cervical cancer, prostate cancer, non-Hodgkin's lymphoma and acute lymphocytic leukemia (n = 10, one case also had DM), autoimmune disease or asthma with long-term steroid usage (n = 4, one case also had DM), liver cirrhosis (n = 2) and chronic renal insufficiency (n = 1). Four patients had no abscess formation at presentation (invasive or early purulent stage), while the remaining 36 cases presented with at least one abscess (purulent stage). Patients older than 40 years or DM patients tended to have larger abscess(s) (P < .05). Gadolinium-enhanced images demonstrated either thick (n = 12) or thin rim enhancement (n = 24) of the abscess wall. For those 10 patients promptly treated solely with antibiotics, nine demonstrated thin rim enhancement of the abscess (P < .05). CONCLUSION: Magnetic resonance imaging plays an important role in the early recognition of bacterial PM. By precisely demarcating the extent of the disease, MRI can allow planning prompt antibiotic treatment combined with or without interventional procedures.

Abscess↗
PubMed2003

A case confirming the progressive stages of pyomyositis.

A teenage boy presented in the early stage of pyomyositis. He had neck pain, tenderness, and fever. A computed tomography scan showed inflammation in the sternocleidomastoid muscle with no fluid collection. This progressed to a pus-filled drainable mass caused by Stapylococcus aureus. The authors describe this case to highlight the predictable stages and increase the index of suspicion to enhance its early recognition.

Abscess↗
PubMed1988

Pyomyositis--an under-reported disease in temperate climates.

Two cases of pyomyositis were seen over a period of 2 weeks. Both patients were young local residents in whom large amounts of pus were found deep within skeletal muscles. The first case had an unusual presentation involving more than one muscle. The causative organism in the first case was Staphylococcus aureus. In the second case it was Streptococcus pyogenes.

Adult↗
PubMed1999

Unusual case of septic arthritis of the hip: spread from adjacent adductor pyomyositis.

Distinguishing intracapsular and extracapsular hip infections may be clinically difficult. Because of this difficulty in diagnosis, the spread of an extracapsular infection into the hip joint may be missed and lead to significant joint destruction. The case of a patient who suffered from the spread of adductor pyomyositis to the hip joint is reported. The delay in diagnosis of an intracapsular hip infection led to significant intra-articular destruction and ultimately necessitated a Girdlestone resection arthroplasty. The patient's hip function was salvaged with a total hip arthroplasty. The presence of an extracapsular hip infection should mandate serial physical examinations and aggressive evaluation to rule out intracapsular spread. A delay in diagnosis of an intracapsular hip infection can lead to catastrophic results.

Adult↗
PubMed1995

Bacterial infections: pyomyositis.

Staphylococcal pyomyositis is an important and common condition in many areas in the tropics. The cause is probably multifactorial and includes damage to the skeletal muscle in the presence of staphylococcal bacteraemia, with or without depressed immunity. In Africa, there are indications of an increased prevalence in association with HIV infection in young adults in whom multiple and recurrent abscesses are common. Long bone osteomyelitis is an important differential diagnosis in these patients. Timely surgical drainage and antibiotics leads to resolution. Delayed diagnosis is associated with disseminated disease and septic cardiorespiratory complications.

Bacterial Infections↗
PubMed2001

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.

Aged↗
PubMed1982

Tropical pyomyositis in Saudi Arabia.

Tropical pyomyositis is a disease of skeletal muscle characterised by single or multiple abscesses with Staphylococcus aureus the most commonly isolated organism. Most cases have been reported from the hot and humid tropics. This report reviews the literature, describes a case from hot, dry Saudi Arabia and suggests that such cases may be missed because local clinicians may be unaware of the existence of such a clinical entity.

Abscess↗