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PubMed1988

Pyomyositis in a patient with the acquired immunodeficiency syndrome.

Pyomyositis is an acute bacterial infection of skeletal muscle. It is a common disease in the tropics; fewer than 50 cases of pyomyositis have been reported in the continental United States. Most patients are healthy males, although the disease has been reported in diabetics and in the immunocompromised. This article presents the first detailed known reported case of pyomyositis in a patient with the acquired immunodeficiency syndrome; Staphylococcus aureus was the etiologic agent.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Cardiovascular complications of tropical pyomyositis.

Clinical observations are described in 13 cases of pyomyositis with various cardiovascular complications: (a) pyogenic pericarditis (10 cases) with tamponade in 7 and myopericarditis in 1 case, and (b) acute bacterial endocarditis (3 cases). Blood cultures grew Staphylococcus aureus in all 3 with endocarditis and in 5 of 10 with pericarditis. These complications probably resulted from the bacteraemia which sometimes complicates pyomyositis. Enhanced susceptibility of cardiac muscles to infection in pyomyositis however remains another possibility.

Adolescent↗
PubMedDate not supplied

Peracute streptococcal pyomyositis: report of two cases and review of the literature.

Pyomyositis occurs infrequently in temperate climates. The fulminating peracute form caused by group A Streptococcus is exceedingly rare. We present two children with streptococcal pyomyositis. One child was admitted in septic shock and required intensive supportive care during the acute stage of his illness. Persistent swelling and tenderness of his left thigh presented a diagnostic problem, which was eventually resolved with the aid of computerized tomography. Despite appropriate antibiotic therapy from the onset of illness, surgical debridement of the affected muscle was necessary. The second child presented with pyomyositis of the left paravertebral muscles and signs of incipient shock but did well on antibiotic therapy alone.

Anti-Bacterial Agents↗
PubMed1980

Pyomyositis in childhood.

Twenty-five per cent of 63 Nigerian children aged between 6 months and 12 years with pyomyositis were found to have associated osteomyelitis. Even though the clinical features were generally similar to those in other series, there was a higher incidence of complications and associated disorders, particularly anaemia and septicaemia. Septicaemia was demonstrable at presentation in all these who developed osteomyelitis. The mortality was low at 3% but morbidity was high as a result of the complications which kept many of the cases in hospital for prolonged periods. Attention is drawn to the high frequency of electrolyte and urea abnormalities associated with pyomyositis in the series. These changes, which were multifactorial in causation, must be corrected as part of the overall management of children with pyomyositis.

Abscess↗
PubMed1996

Staphylococcal pyomyositis.

Pyomyositis, a suppurative infection of the skeletal muscle, is uncommon and frequently misdiagnosed. Staphylococcus aureus has been reported as the most common causative organism in the tropics. The purposes of this study were to examine the clinical courses including presentations, treatments, and final outcomes of Staphylococcal pymyositis in Chang Gung Memorial Hospital and to suggest a treatment modality for this disorder. From July 1985 to June 1994, 12 patients were treated in this hospital for Staphylococcal pyomyositis. There were 9 males and 3 females, whose mean age was 22.1 years. The involved patients were either in the first two or in the fifth to seventh decades of life. Fever was found in all of them. The average time lag in diagnosis was 11.8 days from the onset of minor symptoms. The Gallium-67 scan was very sensitive and valuable in localization of the disease. Debridement or surgical drainage of the abscess was done in 11 patients. All the patients recovered after between 4 and 6 weeks of adequate antibiotic treatment without major abnormalities and complications. In summary, Staphylococcal pyomyositis is a rather benign disease. However, diagnosis is often delayed due to its vague presentation and lack of clinical suspicion. Unfamiliarity with this disease may be an obstacle to appropriate management.

Adolescent↗
PubMedDate not supplied

[Pyomyositis in Italy: report of a clinical case].

Pyomyositis is an infection of the striated muscle seen frequently in Africa but rarely in Western countries with a temperate climate. Over the last few years it has been observed with increasing frequency, especially in immunocompromised hosts. An unusual case of pyomyositis in a 65-year-old immunocompetent woman is described. The disease emerged during septicemia caused by Staphylococcus aureus. It was associated with pleuropneumonia and affected two different and opposite groups of muscles. Diabetes mellitus, a known predisposing factor, was diagnosed during the infection. The diagnosis of pyomyositis was based on microbiological cultures, computed tomography, and radio-labelled granulocyte scintigraphy. Follow-up until recovery was based on computed tomography. Surgical drainage of abscesses was avoided thanks to early diagnosis and specific antibiotic therapy.

Aged↗
PubMed1998

Pyomyositis in childhood: a case report.

Pyomyositis is a primary infection of skeletal muscle. We report the case of a previously healthy six-year-old who suffered from pyomyositis in the right lower back. He presented with lower back pain and low-grade fever for one week. After a series of laboratory and imaging studies, the diagnosis of right multifidus muscle pyomyositis with abscess formation was made. The patient recovered rapidly after incision and drainage therapy, accompanied by antibiotic treatment. Methicillin-resistant Staphylococcus aureus was cultured from the abscess discharge. It was strongly suspected that herbal medicines and common cold medication the patient had been prescribed before admission to our hospital produced a masking effect that delayed the diagnosis.

Child↗
PubMed2006

Inverse hypopyon as the presenting feature of infectious scleritis in a case of tropical pyomyositis.

CASE REPORT: A 25-year-old man presented with inverse hypopyon due to dense inflammatory exudation in the left eye. He was an ascetic with a history of long pilgrimages barefoot. Drainage of the pyogenic material with superficial exploration revealed localized scleral thinning at 2'o clock. Two days later, a thigh abscess was noted, which on ultrasonography showed hypoechoic areas with increased muscle mass suggestive of tropical pyomyositis. The culture from anterior chamber aspirate grew Staphylococcus aureus, as did 200 mL of pus drained from the thigh. His ocular condition improved significantly with high-dose systemic antibiotics. COMMENTS: To our knowledge, this unusual presentation of infectious scleritis and coexistent pyomyositis has not been previously reported in the literature.

Adult↗
PubMedDate not supplied

[Primary pyomyositis of the psoas muscles in a temperate climate. Review of two cases in children followed up over the long term].

BACKGROUND: We review two cases of primary pyomyositis of the psoas in children that occurred in Navarre, their management and long-term evolution. Primary pyomyositis of the psoas muscle is a rare infection in a temperate climate. Its diagnosis is difficult due to the similarity of the symptoms with several infectious processes, mainly septic arthritis of the hip in children and adolescents. The rarity of the present cases is due to several facts: occurrence in children, in a temperate climate (Navarre), immunocompetent patients and without subjacent pathology, besides their monofocal situation that is contrary to the more frequent multifocal presentation. These factors, besides the poor specificity of the symptoms, constitute a diagnostic challenge. METHODS: We present two patients (10 and 12 years old) with fever and a painful hip. Neither of the patients had predisposing factors. Both of them showed hip flexion with limited range of motion in rotations. Confirmation of the diagnosis was made by ultrasound, CT-scan and/or MRI. Needle aspiration of the hip, under general anaesthesia, confirmed the reactive origin of the joint effusion in both patients. In neither of the two cases was there a significant diagnostic delay. Staphylococcus aureus was isolated in the purulent material in one case and in the hemoculture in the other. Both patients have been checked in a long-term revision (follow-up of 7 and 10 years). RESULTS: They were successfully treated by isolated antibiotherapy in one case and surgical drainage in the other. Healing was achieved in each case without relapse or sequels in a long-term revision. We carry out a global revision of this rare infection, emphasising the difficulty of its clinical diagnosis and the different treatment modalities and the proper indication. We suggest an algorithm as a clinical guide for its clinical-therapeutic management.

Anti-Bacterial Agents↗
PubMed1984

Pyomyositis. Report of 18 cases in Hawaii.

Eighteen patients with pyomyositis were seen at a large hospital in Hawaii. Most were healthy young men or boys, and eight had never traveled abroad. Fever, muscle pain and swelling, and leukocytosis were common, but only seven had erythema or fluctuance. A single large muscle was infected in 14, and two to three muscles were infected in the others. Pyomyositis mimicked cellulitis, muscle hematoma, thrombophlebitis, appendicitis, and neoplasm. Staphylococcus aureus was found in 13, and Streptococcus pyogenes was found in two. Bacteremia occurred in 29% (5/17). Drainage and antimicrobial agents were usually effective therapy, but one patient died and another had CNS damage. The pathogenesis is uncertain, but 12 had nonpenetrating muscle injury and 13 had pyoderma, suggesting that bacteria invade injured muscle via the bloodstream or lymphatic system.

Adolescent↗
PubMed1975

"Tropical pyomyositis." A diagnostic problem in temperate climates.

Pyomyositis is a common disease in tropical countries, but is believed to be rare in temperate climates. Two children who had never left the northeastern part of the United States developed single intramuscular abscesses. Pyomyositis may be more common in temperate climates than has previously been appreciated.

Abscess↗
PubMed1995

Tropical pyomyositis presenting in the upper extremity.

Tropical pyomyositis is a staphylococcal infection, usually of a single large muscle, most commonly seen in young men in tropical regions. The following presents a case of tropical pyomyositis in a 62-year-old man that affected all four extremities, including the muscles of the forearms. Computed tomography was a useful guide for directing surgical explorations. To decrease the degree of disability from the multiple operative sites, we successfully used limited longitudinal incisions and conservative débridements.

Arm↗
PubMed1990

Nontropical pyomyositis as a cause of subacute, multifocal myalgia in the acquired immunodeficiency syndrome.

We report a case of nontropical pyomyositis in a patient with acquired immunodeficiency syndrome and disseminated Mycobacterium avium infection, in which severe myalgia was the presenting symptom over several weeks. Multifocal muscle lesions were identified by gallium scanning and magnetic resonance imaging techniques. The epidemiology, possible pathogenesis, clinical features, diagnostic imaging, and therapy are reviewed. Early suspicion of nontropical pyomyositis in severely immunocompromised patients with "cryptic" myalgia is recommended.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Ultrasound in tropical pyomyositis.

Tropical pyomyositis is an infection of muscles mainly presenting in black people, occurring in the trunk and limbs. At Hoima Hospital, Uganda, 58 patients (30 men and 28 women) with a mean age of 21 years have been investigated by ultrasound; a total of 81 lesions were present. Two different characteristic images were found; abscess was present in 65 cases while 16 patients showed a diffuse infiltration among the muscular fibers. These two different images correspond to the two stages of histologic and clinical progression described by other authors. Ultrasound is useful to demonstrate the progression of pyomyositis and to determine when and where to drain any abscess.

Adolescent↗
PubMedDate not supplied

Spontaneous pyomyositis and AIDS: an infrequent association.

Pyomyositis is an acute bacterial infection of striated muscle. It is common in the tropics, but rarely reported in temperate climates. We present two cases in patients with the acquired immune deficiency syndrome (AIDS), one an active homosexual, and one an intravenous drug user. A brief review of the clinical findings and diagnostic procedures is included. We conclude that pyomyositis should be included in the list of locations of pyogenic infections that can occur in AIDS patients.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Osteomyelitis in tropical pyomyositis: a case report.

We report a case of acute tropical pyomyositis in a German girl living in Tanzania. The course of the disease was complicated by osteomyelitis affecting the humerus, which is unusual in tropical pyomyositis. Diagnosis of the osteomyelitis was difficult because a scintigram showed depressed bone activity during the isotope influx and bloodpool phase. The bone phase was abnormal with irregular hypo- and hyperfixation of tracer.

Child↗
PubMed2000

Synchronous pyomyositis and septic hip arthritis.

The authors report a rare concomitant pyogenic infection of the iliopsoas, iliacus and external obturator muscles and of the hip joint in a 68-year-old woman. Because the patient showed the classic symptomatic triad of limping, hip pain and fever, in addition to positive hip arthrocentesis, the diagnosis of septic hip arthritis was routine, but the simultaneous pyomyositis was almost overlooked. Unusual localised heat and swelling on the front of the proximal thigh prompted a CT scan that identified remarkable muscle abscesses in addition to the septic arthritis. Surgical debridement and antibiotics resolved the infection relatively rapidly without sequelae. We noted that reaching a definitive diagnosis of such a concomitant infection requires a suspicion of the presence of pyomyositis, which can be definitively determined using advanced imaging studies.

Aged↗