Streptococcal Pyomyositis of the Psoas

Kern, Leah; Rassbach, Caroline; Ottolini, Mary

doi:10.1097/01.pec.0000210177.48386.e7

Cited by 14 publications

(17 citation statements)

References 19 publications

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“…Primary psoas abscesses due to hematogenous seeding involve S. aureus in approximately 80 to 90% of cases (91); recent cases have shown that community-acquired MRSA is a new cause of primary psoas abscesses (219,254). Other pathogens have been described, including streptococci such as S. pneumoniae, S. milleri, or group A streptococci (14,124). Figure 1 shows a multiloculated psoas abscess which developed insidiously in an HIV-positive patient who presented with fevers and back pain; the culture grew group A streptococci.…”

Section: Psoas Abscessmentioning

confidence: 99%

Bacterial, Fungal, Parasitic, and Viral Myositis

2008

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SUMMARY Infectious myositis may be caused by a broad range of bacterial, fungal, parasitic, and viral agents. Infectious myositis is overall uncommon given the relative resistance of the musculature to infection. For example, inciting events, including trauma, surgery, or the presence of foreign bodies or devitalized tissue, are often present in cases of bacterial myositis. Bacterial causes are categorized by clinical presentation, anatomic location, and causative organisms into the categories of pyomyositis, psoas abscess, Staphylococcus aureus myositis, group A streptococcal necrotizing myositis, group B streptococcal myositis, clostridial gas gangrene, and nonclostridial myositis. Fungal myositis is rare and usually occurs among immunocompromised hosts. Parasitic myositis is most commonly a result of trichinosis or cystericercosis, but other protozoa or helminths may be involved. A parasitic cause of myositis is suggested by the travel history and presence of eosinophilia. Viruses may cause diffuse muscle involvement with clinical manifestations, such as benign acute myositis (most commonly due to influenza virus), pleurodynia (coxsackievirus B), acute rhabdomyolysis, or an immune-mediated polymyositis. The diagnosis of myositis is suggested by the clinical picture and radiologic imaging, and the etiologic agent is confirmed by microbiologic or serologic testing. Therapy is based on the clinical presentation and the underlying pathogen.

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Section: Psoas Abscessmentioning

confidence: 99%

Bacterial, Fungal, Parasitic, and Viral Myositis

2008

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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: 77%

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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“…The differential includes cellulitis, myositis, osteomylelitis, pyomyositis, abscess, and necrotizing fasciitis. 8,9 The presence of phleboliths is diagnostic of a cavernous hemangioma, although it was not initially recognized. In otherwise healthy individuals, group A streptococcus (GAS) is the most common cause of invasive soft tissue infection.…”

Section: Discussionmentioning

confidence: 97%

“…In otherwise healthy individuals, group A streptococcus (GAS) is the most common cause of invasive soft tissue infection. 8 Before the emergence of Methicillin-resistant Staphylococcus aureus that has been noted in the last 5 years, the incidence of invasive GAS disease had been noted to be on the rise since the 1980s in much of the United States. 10 A review of the literature shows limited data regarding intramuscular hemangiomas in pediatric patients and even fewer cases of infected hemangiomas.…”

Section: Discussionmentioning

confidence: 99%

Group A Streptococcal Infection of an Intramuscular Venous Malformation

Russell¹,

Watts²,

Royal³

et al. 2008

Pediatric Emergency Care

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Intramuscular venous malformations are uncommon benign masses of vascular origin that can occur anywhere in the body. They can be small and clinically insignificant or can be large and violate tissue planes and viscera. Presentation is as variable as the extent of the lesions. They can be diagnosed as a result of local pain and swelling or as incidental findings. Rarely, venous malformations can get infected and present with fever or other more severe systemic symptoms. The literature is sparse regarding infection of intramuscular venous malformations. This case describes the presentation, diagnosis, and management of a patient with group A streptococcal infection of a previously undiagnosed intramuscularvenous malformation in a patient who presented to our pediatric emergency department.

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Streptococcal Pyomyositis of the Psoas

Cited by 14 publications

References 19 publications

Bacterial, Fungal, Parasitic, and Viral Myositis

Bacterial, Fungal, Parasitic, and Viral Myositis

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

Group A Streptococcal Infection of an Intramuscular Venous Malformation

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