Primary Tuberculous Pyomyositis of the Calf Muscles

Al-Khazraji, Ahmed; Takher, Jasprit; Alkhawam, Hassan; Fabbri, Marilyn

doi:10.1016/j.amjms.2016.05.010

Cited by 9 publications

(6 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This symptom and location were distinctive features for MT and should be included in the differential diagnostic criteria for other muscular nodular diseases. In five cases (including case 1 in the present report), the patient had suffered from pulmonary TB or had a history of contact with patients with suspected TB ( 3 , 14 , 21 , 29 ). At present, it is generally agreed that hematogenous dissemination plays an important role in MT, although in some cases it was transmitted through an infected needle ( 3 , 6 , 15 , 20 , 21 ).…”

Section: Discussionmentioning

confidence: 81%

“…Skeletal muscles were usually spared by TB because these are a poor host for mycobacterium tuberculosis ( 30 ). In consideration of MT occurring as a secondary infection, patients in four cases had been treated with steroids, and long-term chronic pulmonary inflammation or decreased immunity may therefore be a potential risk factor for MT ( 3 , 9 , 18 , 27 , 29 ). The clinical symptom in case 1 was painful isolated masses in the lower limbs, and EMG suggested potential generalized involvement of peripheral nerves with axonal damage.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Case report: Muscular tuberculosis with lower-extremity muscular masses as the initial presentation: Clinicopathological analysis of two cases and review of the literature

et al. 2023

View full text Add to dashboard Cite

BackgroundTuberculosis (TB) is a threat to public health that mostly affects people in developing countries. TB presenting as a soft tissue mass is rare and is usually seen in patients with muscular tuberculosis (MT).Case presentationIn this study, we present the clinical, radiographic, and pathological features of two cases and retrospective evaluations of an additional 28 patients who were diagnosed with MT. More patients were men (60.9%) than women (39.1%), with a male-to-female ratio of 1.6:1. The average age among male and female patients was 38.9 and 30.1 years, respectively. MT usually presents with painful or painless muscular nodules on the lower limbs. Imaging findings, including ultrasound, CT, and MRI, can be used to identify lesions and sites for biopsy. The most typical histopathological feature of MT is granulomatous inflammation with caseous necrosis and epithelioid granulomata. Acid-fast bacilli stain and polymerase chain reaction (PCR) assays are helpful in identifying tubercle bacillus.ConclusionWe describe two MT cases with lower-extremity muscular masses as the initial presentation. The results suggest that muscle biopsy and pathological analysis remain necessary for diagnosis. Most of the patients could be cured with standard antituberculosis therapy.

show abstract

Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Case report: Muscular tuberculosis with lower-extremity muscular masses as the initial presentation: Clinicopathological analysis of two cases and review of the literature

et al. 2023

View full text Add to dashboard Cite

show abstract

“…The literature search yielded 280 articles, of which 52 articles (Fig. 3) reporting 67 cases were included for review; these comprised case series of 2 to 10 patients 2–6 and many case reports, 7–53 thus including the index case reported by us; 68 cases of primary tuberculous myositis were analyzed. A majority were Asian (69%), and mean age at presentation was 38.7 (±18.6) years (Supplemental Table 1, http://links.lww.com/RHU/A221).…”

Section: Results Of the Systematic Reviewmentioning

confidence: 99%

“…Thirty-one patients (46%) had an underlying disease that could (by itself or by way of therapy) predispose to tuberculosis. These included dermatomyositis (7 patients), 4,5,18,29,30,35 systemic lupus erythematosus (4 patients), 4,27,52,53 rheumatoid arthritis (2 patients), 26,44 ankylosing spondylitis (1 patient), 19 polymyalgia rheumatica (1 patient), 32 Sjögren syndrome (1 patient), 25 polymyositis (2 patients), 5,8 human immunodeficiency virus (1 patient), 20 postrenal transplant status (3 patients), 36 sarcoidosis (1 patient), 38 acute myeloid leukemia (2 patients), 21 diabetes mellitus (2 patients), 32,36 hepatitis B virus infection (1 patient), 4 hepatitis C virus infection (1 patient), 36 chronic kidney disease (1 patient), 47 and overlap connective tissue syndrome (1 patient). 50…”

Section: Clinical Featuresmentioning

confidence: 99%

Primary Tuberculous Myositis—Report of a Case and Systematic Review of Literature in the Last 25 Years

et al. 2020

View full text Add to dashboard Cite

M ycobacterium tuberculosis infects approximately 1.7 billion people in the world and causes disease in 10 million annually. Musculoskeletal tuberculosis accounts for 2% to 5% of cases, generally presenting as Pott's spine or large joint arthritis 1 ; the involvement of muscle by tubercle bacilli, referred to as tuberculous myositis, is rare. Muscle involvement can occur either due to hematogenous spread (primary) or as a result of extension from a contiguous site (secondary); the former being less common. 2 We report a case of primary tuberculous myositis and review all cases published in the last 25 years. CASE REPORTA 49-year-old man was admitted with swelling and dullaching pain over the right gluteal region, fever, and loss of appetite for 6 months. Three years prior to the current presentation, he had been diagnosed with dermatomyositis and treated with corticosteroids and azathioprine; these drugs were tapered and stopped after 2 years. With a possibility of relapse, corticosteroids were restarted 1 month before his admission.On examination, a localized tender swelling was present over the right gluteal area and posterior thigh, extending to the knee. Magnetic resonance imaging of this region revealed active myositis of the gluteal muscle and muscles in the posterior compartment of the right thigh (Figs. 1A, B). Positron emission tomographycomputed tomography showed uptake in these muscles, and an image-guided biopsy was performed. This revealed granulomatous inflammation on histopathology (Fig. 2), and a cartridge-based nucleic acid amplification test GeneXpert MTB/RIF (Cepheid, Sunnyvale, CA) detected M. tuberculosis. Computed tomography of the thorax did not show any pulmonary tuberculosis; however, tuberculin skin test was positive. Antitubercular therapy was started with isoniazid, rifampicin, ethambutol, and pyrazinamide for 2 months, followed by isoniazid, rifampicin, and ethambutol for 8 months. The fever resolved within 2 weeks, and over the next few months, the swelling subsided, and the patient gained weight. At 1 year, he was found to be asymptomatic and disease-free. METHODS FOR SYSTEMATIC REVIEWWe carried out a search in PubMed (MEDLINE), Scopus, EMBASE, and Web of Science, using the words "tubercular myositis," "tubercular pyomyositis," "tuberculous myositis," or "tuberculous pyomyositis." This review was restricted to articles in English language that were published between January 1995 and December 2019. Abstracts and full texts of relevant articles were examined by 2 authors (H.S., V.D.), and those articles that described cases of primary tuberculous myositis confirmed by microbiological tests (or on histopathology) were included for review. The outcome of cases was noted, factors associated with death analyzed, and odds ratios (ORs) (95% confidence intervals [CIs]) calculated. Analysis was done by GraphPad Prism (version 8 for Windows, La Jolla, CA).

show abstract

“…Regarding pyomyositis, up to 90% of patients are diagnosed at the second stage, also known as the purulent stage 7. However, during this stage, a lack of speciﬁc signs and symptoms as well as atypical manifestations may also be observed in patients with SLE 5 20 41–43. In SLE child patients, pyomyositis is extremely rare with a prevalence of only 0.35% (1/289) 25.…”

Section: Discussionmentioning

confidence: 99%

Severe thoracic pyomyositis in a patient with systemic lupus erythematosus

et al. 2022

View full text Add to dashboard Cite

Pyomyositis may mimic deep vein thrombosis and be misdiagnosed in patients with systemic lupus erythematosus (SLE). We report here on patient with SLE with severe thoracic pyomyositis presented with right upper arm swelling and fever. The patient fully recovered after a serial surgical debridement and antibiotic therapy. Pyomyositis, as well as deep vein thrombosis, should be considered during the differential diagnosis of patients with SLE experiencing fever and unilateral limb oedema. CT and identification of causal pathogens are crucial in the diagnosis of pyomyositis. Early effective antibiotic treatment as well as surgical intervention can together bring about a better outcome.

show abstract

Primary Tuberculous Pyomyositis of the Calf Muscles

Cited by 9 publications

References 5 publications

Case report: Muscular tuberculosis with lower-extremity muscular masses as the initial presentation: Clinicopathological analysis of two cases and review of the literature

Case report: Muscular tuberculosis with lower-extremity muscular masses as the initial presentation: Clinicopathological analysis of two cases and review of the literature

Primary Tuberculous Myositis—Report of a Case and Systematic Review of Literature in the Last 25 Years

Severe thoracic pyomyositis in a patient with systemic lupus erythematosus

Contact Info

Product

Resources

About