Pyomyositis as the Presenting Feature of Acute Lymphocytic Leukemia

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

“…A total of 14 cases of pyomyositis in children affected by hematological malignancy were reported (Table 1). In most cases, local muscular pain was the main reported symptom (11/14), [7][8][9][10][11][12][13][14][15] whereas fever was not always present. A minority of patients presented a tense palpable mass or multiple nodular lesions (3/14) 10,11,16 ; redness and skin warmth in the area were reported only in 2 cases.…”

“…A minority of patients presented a tense palpable mass or multiple nodular lesions (3/14) 10,11,16 ; redness and skin warmth in the area were reported only in 2 cases. 9,13 The majority of children (10/14) were affected by ALL. Most patients developed pyomyositis during most therapyintense phases of chemotherapy (7 during induction and 2 during reinduction phases).…”

“…14 In most cases (9/14), MRI was performed as the first radiologic examination to detect the muscular infection. 8,[11][12][13][14][15][16][17] When ultrasound was chosen as the first radiologic examination (2/14), it resulted diagnostic, showing an abscess, 7,10 yet it is unclear if it would have been similarly diagnostic in the earlier, nonsuppurative phases of the infection. Evolution in muscular abscess occurred in most patients (10/14) during the course of infection, despite intravenous antibiotic therapy, and was followed by drainage.…”

“…Evolution in muscular abscess occurred in most patients (10/14) during the course of infection, despite intravenous antibiotic therapy, and was followed by drainage. [7][8][9][10][13][14][15][16][17] Methicillin-sensitive S. aureus was the most common causative agent, isolated in cultures in 9/14 patients, whereas only 1 patient grew a Gram-negative species (Escherichia coli) and 1 patient had a fungus isolated from cultures (Acremonium spp. ).…”

Secondary myopathy due to systemic diseases

“…In single cases, chronic lymphatic leukemia may go along with inclusion body myositis . Pyomyositis may be the initial presentation not only of chronic myeloid leukemia but also of acute lymphocytic leukemia . In a girl with secondary acute myelogenous leukemia following chemotherapy, tuberculous myositis developed .…”