Primary pyomyositis in children: a retrospective analysis of 11 cases

Abstract

This study was undertaken to review our approach to diagnosis and treatment in a series of 11 patients (mean age 8.2 years) with primary pyomyositis, who had neither an underlying disease nor a compromised immune system. Nine of the children had positive blood cultures, Staphylococcus aureus (eight) and Streptococcus group A (one). The sites of infection were iliopsoas (four), obturator (two), hip adductors (two), levator scapula (one), thoracolumbar paraspinal (one) and gastrocnemius (one) muscles. Antibiotic treatment was initially intravenous, followed by oral administration. Of five patients with evidence of abscess formation, three underwent percutaneous drainage, whereas two required open surgical drainage. The infection resolved completely without any sequela in 10 children. One patient who developed acute compartment syndrome showed late signs of osteonecrosis of the tibial shaft segment.

Primary obturator-muscle pyomyositis in immunocompetent children

“…If not treated appropriately, however, it can relapse [38] or progress to acute compartmental syndrome and osteonecrosis [13], solid-organ impairment, and even septic shock and death [38].…”

Pyomyositis; Frequency and Its Common Bacteria With Their Antibiotic Sensitivity Among Children With Highly Suspected Clinical Features

“…1 Pyomyositis is a common clinical presentation in outpatient department of orthopedics, general surgery and medicine accounting for about 4% of hospital admission in tropical countries. 2 It may present as a single or multiple abscesses.…”

Pyomyositis and bacteremia due to Staphylococcus aureus as onset of acute promyelocytic leukemia

“…It is characterized by suppuration within the muscle with formation of abscesses. 1 Classically, pyomyositis has been described in tropical countries, associated with repetitive trauma in malnourished people, but in recent years it has been reported in nontropical areas, particularly in immunocompromised hosts. 2 It is not infrequent that more than one muscle group is affected.…”

“…1 Magnetic resonance imaging is the diagnostic tool of choice, because it is able to delineate the extension of the infection. 4 Aspiration of fluid under US or computed tomography is usually recommended for microbiological testing.…”