Pseudomonas aeruginosa Pyomyositis in a Child With Acute Lymphoblastic Leukemia: A Case Report and Review of Literature

Migliarino, Vanessa; Naviglio, Samuele; Barbi, Egidio; Rabusin, Marco

doi:10.1097/mph.0000000000002029

Cited by 4 publications

(1 citation statement)

References 23 publications

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“…According to Ngor et al [ 5 ], individuals with HIV infection were five times more likely to be diagnosed with pyomyositis than those uninfected. Meesiri [ 12 ] suggested an association between pyomyositis and systematic lupus erythematosus, while other authors suggested a correlation between hematological malignancies and pyomyositis [ 13 – 15 ]. Most patients show a full recovery with no long-term complications.…”

Section: Introductionmentioning

confidence: 99%

Arthritis or an Adjacent Fascial Response? A Case Report of Combined Pyomyositis and Aseptic Arthritis

Martonovich,

Reisfeld,

Yonai

et al. 2024

Case Reports in Rheumatology

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Pyomyositis, accompanied by aseptic arthritis, has been previously documented in several publications. However, none of the authors in the mentioned case reports offered a pathophysiological explanation for this unusual phenomenon or proposed a treatment protocol. We present a case of a healthy, 70‐year‐old male who was presented to the emergency department 4 days after tripping over a pile of wooden planks and getting stabbed by a nail to his thigh. The right thigh was swollen. Unproportional pain was produced by a light touch to the thigh. A laboratory test and a CT scan were obtained. The working diagnosis was pyomyositis of the thigh and septic arthritis of the ipsilateral knee. The patient underwent urgent debridement and irrigation of his right thigh. An arthroscopic knee lavage was performed as well. Intraoperative cultures from the thigh revealed the growth of Streptococcus pyogenes and Staphylococcus aureus. Cultures from synovial fluid were sterile; thus, septic arthritis was very unlikely. The source of the knee effusion might have been an aseptic inflammatory response due to the proximity of the thigh infection. Anatomically, the quadriceps muscle inserts on the patella, and its tendon fuses with the knee capsule, creating a direct fascial track from the thigh to the knee. The inflammatory response surrounding the infection may have followed this track, creating a domino effect, affecting adjacent capillaries within the joint capsule, and causing plasma leakage into the synovial space, leading to joint effusion. Our suggested treatment is addressing the primary infection with antibiotics and considering adding anti‐inflammatory therapy, given our suspicion that this process has an inflammatory component.

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Section: Introductionmentioning

confidence: 99%

Arthritis or an Adjacent Fascial Response? A Case Report of Combined Pyomyositis and Aseptic Arthritis

Martonovich,

Reisfeld,

Yonai

et al. 2024

Case Reports in Rheumatology

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Pyomyositis

Ranade

Gopinathan

Vij

et al. 2022

Pediatric Musculoskeletal Infections

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Pelvic Pyomyositis in Childhood: Clinical and Radiological Findings in a Tertiary Pediatric Center

et al. 2022

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Pyomyositis (PM) is an infrequent but increasing bacterial infection of the skeletal muscle, with muscles of the pelvis and thigh frequently involved. The diagnosis is often challenging, especially when a deep muscle is affected. We present a single-center pediatric cohort affected by pelvic PM. A retrospective analysis was performed, including children admitted to Meyer Children’s Hospital between 2010 and 2020. Demographic, anamnestic, clinical, laboratory, radiological and management data were collected. Forty-seven patients (range 8 days–16.5 years, 66% males) were selected. Pain (64%), functional limitations (40%) and fever (38%) were the most common presenting symptoms; 11% developed sepsis. The median time to reach the diagnosis was 5 days (IQR 3–9). Staphylococcus aureus was the most common organism (30%), Methicillin-Resistant S aureus (MRSA) in 14%. PM was associated with osteomyelitis (17%), arthritis (19%) or both (45%). The infection was multifocal in 87% of children and determined abscesses in 44% (40% multiple). Pelvic MRI scan, including diffusion-weighted imaging (DWI), always showed abnormalities when performed. Clinical and laboratory findings in pelvic PM are unspecific, especially in infancy. Nevertheless, the infection may be severe, and the suspicion should be higher. MRI is the most useful radiological technique, and DWI sequence could reveal insidious infections.

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Pseudomonas aeruginosa Pyomyositis in a Child With Acute Lymphoblastic Leukemia: A Case Report and Review of Literature

Cited by 4 publications

References 23 publications

Arthritis or an Adjacent Fascial Response? A Case Report of Combined Pyomyositis and Aseptic Arthritis

Arthritis or an Adjacent Fascial Response? A Case Report of Combined Pyomyositis and Aseptic Arthritis

Pyomyositis

Pelvic Pyomyositis in Childhood: Clinical and Radiological Findings in a Tertiary Pediatric Center

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