A young goalkeeper with buttock pain and fever

Moressa, Valentina; Pastore, Serena; Naviglio, Samuele; Ventura, Alessandro

doi:10.1136/bmj.j2400

Cited by 3 publications

(6 citation statements)

References 8 publications

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“…Leukocytosis and neutrophilia are present in 50-60% of cases and inflammatory markers (ESR and CRP) are universally increased. 3,4 On the other hand, CK values are often normal because the abscess develops between muscle fibers, without myocyte damage. 3 In pyomyositis, only 2/3 of patients have positive blood cultures.…”

Section: Discussionmentioning

confidence: 99%

“…3 Ultrasound is a widely available technique, but it can fail the diagnosis, especially in the early stages of the disease or in cases of deep muscle involvement. 4 The high sensitivity (85%) of bone scintigraphy allows the detection of subtle and early functional changes without anatomical translation in radiological studies; however, it is a low-specificity test (25%), so it should not be a first-line exam. 14,15 The CT scan can identify muscle abscesses, but it fails to identify early inflammatory changes.…”

Section: Discussionmentioning

confidence: 99%

“…1,3 Staphylococcus aureus is the most frequent causative agent. 2,3,4,5 Pyomyositis predominantly affects the muscles of the pelvic region and lower limbs, however, any muscle can be involved. Infection of the internal or external obturator muscles is extremely rare.…”

Section: Introductionmentioning

confidence: 99%

“…MRI remains the gold standard in the diagnosis of this pathology. 4,5 Treatment of pyomyositis abscess has traditionally been based on percutaneous or surgical drainage followed by a prolonged course of ATB.…”

Section: Introductionmentioning

confidence: 99%

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Pelvic pyomyositis and abscess of the internal obturator muscle: case successfully managed with conservative treatment

Ramos¹,

Brito²,

Almeida³

et al. 2022

Pediatric Oncall

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Pyomyositis is a bacterial infection of striated muscle. It is a rare and potentially fatal pathology that usually progresses to intramuscular abscess. Its diagnosis can be difficult due to the clinical similarity with more frequent disorders. Magnetic Resonance Imaging (MRI) is the gold standard for an early diagnosis.Most authors recommend percutaneous or surgical drainage followed by antibiotics (ATB), if an abscess is found. There are few cases described in the literature treated with exclusive ATB.We report the case of an adolescent male with pyomyositis, and an abscess of the right internal obturator muscle successfully treated with conservative treatment. We aim to highlight that uncomplicated pyomyositis abscess in children may be managed without the need of percutaneous or surgical drainage.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pelvic pyomyositis and abscess of the internal obturator muscle: case successfully managed with conservative treatment

Ramos¹,

Brito²,

Almeida³

et al. 2022

Pediatric Oncall

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“…Pyomyositis is a suppurative infection of skeletal muscle usually owing to hematogenous spread of bacteria. Once considered mostly a disease of tropical climates, it has been increasingly reported also in temperate areas, where it often occurs in patients with a history of trauma or underlying predisposing conditions, including immunodeficiency, immunosuppression, injective drug use, vascular devices, or concurrent infections 1–3. It has been seldom reported in children with hematological malignancies, in whom it can nevertheless result in significant morbidity and delay of therapies.…”

mentioning

confidence: 99%

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

Migliarino

Naviglio

Barbi

et al. 2020

Journal of Pediatric Hematology/Oncology

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Background: We report the case of an 11-year-old girl with a recent diagnosis of common B-cell acute lymphoblastic leukemia who presented with Pseudomonas aeruginosa pyomyositis of the left lower limb during severe neutropenia associated with the induction phase of chemotherapy. Observations: Presenting signs included fever, leg pain, and refusal to walk. Popliteal knee ultrasonography was unremarkable, whereas magnetic resonance imaging showed 2 intramuscular fluid collections requiring surgically drainage. Conclusion: A review of medical literature showed that pyomyositis is an infrequent complication in children with hematological malignancies, and most cases are due to Staphylococcus aureus, whereas Pseudomonas aeruginosa appears to be rarely involved.

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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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A young goalkeeper with buttock pain and fever

Abstract: n/

Cited by 3 publications

References 8 publications

Pelvic pyomyositis and abscess of the internal obturator muscle: case successfully managed with conservative treatment

Pelvic pyomyositis and abscess of the internal obturator muscle: case successfully managed with conservative treatment

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

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

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