Pneumococcal Pyomyositis: Report of 2 Cases and Review of the Literature

Zadroga, Rebecca; Zylla, Dylan; Cawcutt, Kelly; Musher, Daniel M.; Gupta, Pankaj; Kuskowski, Michael A.; Dincer, Ayse P.; Kaka, Anjum S.

doi:10.1093/cid/cis424

Cited by 16 publications

(12 citation statements)

References 28 publications

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“…The most common cause of PM is Staphylococcus aureus. It is suggested that trauma is a facilitating factor for microorganism invasion in patients with PM, [1][2][3][4][5] but trauma has been reported in only about 10% of PM patients (in our case there was a possibility of accidental trauma caused by the patient's brother). Thus, invasion of pneumococci to the hip muscle might be facilitated by this event during the bacteremia caused by S. pneumoniae.…”

Section: Discussionmentioning

confidence: 58%

A 10-Week-Old Female with Fever and an Inability to Move Her Left Leg

Aldemir-Kocabaş¹,

Karbuz²,

Fítöz³

et al. 2014

Pediatr Ann

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Editor's note: Each month, this department features a discussion of an unusual diagnosis. A description and images are presented, followed by the diagnosis and an explanation of how the diagnosis was determined. As always, your comments are welcome via email at pedann@Healio.com. For diagnosis, see page 443Case Challenge A previously healthy 10-weekold female was admitted to our hospital with a fever and an inability to move her left leg. The mother also noted a decrease in the child's breast-feeding in the 3 days prior to presentation. Although there was no history of major trauma, it was revealed that her brother had picked her up roughly by her leg 5 days before her admission. On initial physical examination, she had increased capillary refill and tachycardia with toxic appearance. Flexion-adduction and internal rotation posture, and warmth, tenderness, and limitation of movement of the left hip joint were detected. Her laboratory findings were as follows: white blood cell count of 11700/mm 3 , erythrocyte sedimentation rate of 87 mm/h, and C-reactive protein level of 86 mg/L.

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Section: Discussionmentioning

confidence: 58%

A 10-Week-Old Female with Fever and an Inability to Move Her Left Leg

Aldemir-Kocabaş¹,

Karbuz²,

Fítöz³

et al. 2014

Pediatr Ann

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“…Our findings are in line with literature data suggesting a strong correlation between infectious myositis and underlying medical conditions. 3,17,20,21 This was verified for all bacterial responsible strains even if a distinction must be made as concerns E. coli myositis. In fact, of 18 cases reported in literature up till December 2014 6,22-24 almost all patients (94%) were severely immune-compromised for malignancy (mainly hematologic) or HIV-AIDS.…”

Section: Discussionmentioning

confidence: 68%

Adult bacterial myositis: report of a single-center series of 26 cases

Gallucci

Ronga

Pietto³

et al. 2016

Ital J Med

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Bacterial infections involving muscle are quite uncommon and generally require specific predisposing factors. Bacterial myositis is more rarely described in the typical kind of patients observed in Internal Medicine (presence of multiple co-morbidities, partial/limited immune-deficiency, advanced age). Twenty-six patients suffering from bacterial myositis (8 women and 18 men; mean age 58.5 years, range 27-82) observed in a single Internal Medicine Unit were reported. Muscles involved were ileopsoas, thigh, paravertebral, gluteus, calf, forearm and rectus abdomen. Simultaneous presence of arthritis was registered in 17 patients and all patients presented relevant comorbidity. Main cultured bacteria were <em>Staphylococcus aureus, Escherichia coli</em>, other Gram-negative bacteria, <em>Streptococcus spp.</em> Multi-drug-resistance was observed in 14 out 26 (53.8%). Computed tomography, ultrasound and magnetic resonance imaging were utilized for diagnostic purposes. Antibiotic treatment was administered to all patients. Surgical debridement and drainage were performed in 12 patients; 7 patients were treated with percutaneous aspiration and drainage. At discharge, relevant functional impairment was present in 17 patients (65.3%). Four patients died (in-hospital mortality 7.6%, global mortality at three months 15.3%). Management of bacterial myositis is difficult and its prognosis is poor. In the near future, this demanding infection will be more frequently observed in Internal Medicine setting as comorbidity, which is very often the main characteristic of these patients.

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“…Second, the patient's neck pain, serum CK and MRI abnormalities improved with antimicrobial therapy. Few cases of pneumococcal myositis have been reported (2). The previous cases involved other regions (2-4); streptococcal pyomyositis in the neck muscles is very rare.…”

Section: Discussionmentioning

confidence: 99%

Pneumococcal Pyomyositis of the Neck Muscles

et al. 2016

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High fever, severe neck pain and neck stiffness can result from meningitis. We report a case of pneumococcal pyomyositis of the neck muscles. A 72-year-old man developed high fever and severe neck pain. His chief complaint mimicked bacterial meningitis. Although his condition was initially suspected to be bacterial meningitis, his cerebrospinal fluid did not show pleocytosis. MRI showed areas of high intensity in the posterior deep neck muscles on short tau inversion recovery (STIR) sequences and gadolinium-enhanced T1-weighted images. Pneumococcal myositis should therefore be included in the differential diagnosis of severe neck pain with fever.

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Pneumococcal Pyomyositis: Report of 2 Cases and Review of the Literature

Cited by 16 publications

References 28 publications

A 10-Week-Old Female with Fever and an Inability to Move Her Left Leg

A 10-Week-Old Female with Fever and an Inability to Move Her Left Leg

Adult bacterial myositis: report of a single-center series of 26 cases

Pneumococcal Pyomyositis of the Neck Muscles

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