Primary erector spinae pyomyositis causing an epidural abscess: case report and literature review

Marshman, Laurence A.G.; Bhatia, Chandra; Krishna, Manoj; Friesem, Thai

doi:10.1016/j.spinee.2006.12.011

Cited by 18 publications

(18 citation statements)

References 15 publications

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“…Primary erector spinae pyomyositis cases were reported, and abscess was unilateral and localized [3,4]. In the present case, erector spinae muscle myositis was demonstrated to be bilateral, and infectious disease was unlikely to be the cause of erector spinae myositis.…”

Section: C D) Tests For Procalcitonin and β -D-glucan Were Negativementioning

confidence: 43%

Magnetic Resonance Imaging of Dermatomyositis with Bilateral Involvement of the Erector Spinae Muscle

et al. 2016

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A 58-year-old man had been diagnosed with dermatomyositis and interstitial lung disease in August 2002. Although muscle biopsy was not performed, our patient fulfilled the criteria for dermatomyositis published by Bohan and Peter based on the presence of proximal muscle weakness, elevated serum muscle enzyme levels, electromyographic abnormalities, and Images and SolutionEwha Med J 2016;39(3):93-94 http://dx

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Section: C D) Tests For Procalcitonin and β -D-glucan Were Negativementioning

confidence: 43%

Magnetic Resonance Imaging of Dermatomyositis with Bilateral Involvement of the Erector Spinae Muscle

et al. 2016

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“…The Open Spine Journal, 2010, Volume 2 19 erector spinae muscles as seen in our case [6,7]. The combination of both these lesions in an immunocompetent person is extremely rare.…”

Section: Pyogenic Epidural Abscess With Primary Erector Spinae Pyomyomentioning

confidence: 52%

“…The combination of both these lesions in an immunocompetent person is extremely rare. Review of literature shows an isolated case report of pyomyositis with extradural abscess [6]. Staphylococcus aureus was the usual pathogen in both these lesions [8,9].…”

Section: Pyogenic Epidural Abscess With Primary Erector Spinae Pyomyomentioning

confidence: 99%

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Pyogenic Epidural Abscess with Primary Erector Spinae Pyomyositis - Case Report~!2010-04-29~!2010-05-23~!2010-08-02~!

Srinivasan¹

2010

TOSPINEJ

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Abstract:Introduction: Pyogenic epidural abscess associated with primary pyomyositis of erector spinae in an immunocompetent individual is extremely rare. Here we report such a case which has been successfully managed. Materials and Methods:A 26 year old man presented with severe pain in the low back region radiating to both the legs of 3 weeks duration. He was initially suspected to have prolapsed lumbar disc and treated conservatively without relief of symptoms. He had low grade fever on admission with no obvious systemic source of sepsis. Examination revealed only a positive straight leg raising test on both the sides with paravertebral muscle spasm and tenderness over the lumbar region without any other neurological deficit.Results: Laboratory results showed leucocytosis, neutrophilia, elevated erythrocyte sedimentation rate and C-reactive protein. Magnetic resonance imaging (MRI) of the spine with contrast revealed an extensive L3 -S1 epidural abscess with multiple loculated collection of pus in the erector spinae muscles suggestive of pyomyositis. Abscess from the lumbar paravertebral muscles was drained, L5 bilateral laminectomy was performed and extradural abscess was completely evacuated. Pain was completely relieved in the immediate post operative period. Culture revealed growth of staphylococcus aureus which was sensitive to most of the antibiotics except oxacillin. Patient was treated with intravenous vancomycin for 3 weeks which was followed by oral linezolid for 3 weeks combined with oral ofloxacin for 6 weeks. Follow up spinal MRI scan with contrast performed after 6 months was normal. There was no recurrence of symptoms even at the end of 7 months. Conclusion:Pyogenic spinal infection associated with paraspinal muscle abscess must always be considered when back pain with leg pain is associated with fever, leucocytosis and elevated ESR. Staphylococcus aureus is the most common pathogen in these cases. Hematogenous spread of infection through the venous communication between the external vertebral venous plexus with the internal vertebral veins, resulting in simultaneous abscess formation in both the sites is the probable pathogenesis in our case. Early surgical drainage of the abscess from both the sites, with concurrent use of antibiotic therapy for 6 weeks based upon the sensitivity of the organism is required to achieve an excellent outcome.

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“…Marshman et al 23 descreveram recentemente o primeiro caso de abscesso epidural em um paciente com piomiosite tropical do sexo feminino de 56 anos de idade. Apresentamos neste trabalho o segundo caso descrito e o primeiro caso brasileiro apresentando abscesso epidural como complicação de piomiosite.…”

Section: Discussionunclassified

Abscesso epidural em paciente portador de piomiosite tropical: relato de caso e revisão da literatura

Rezende¹,

Cardoso²,

Oliveira³

et al. 2012

Coluna/Columna

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A piomiosite é uma infecção muscular profunda subaguda que pode originar abscessos intramusculares únicos ou múltiplos. Está associada a infecções sistêmicas, diabetes mellitus, terapia imunossupressora, AIDS e mieloma múltiplo. Descrevemos um caso de piomiosite tropical com acometimento da coluna vertebral que evoluiu para abscesso epidural, em paciente com história pregressa de espondilite anquilosante em tratamento com medicações imunossupressoras e apresentou trauma direto na coxa direita previamente ao início dos sintomas. O objetivo deste trabalho é descrever o acometimento raro da coluna vertebral em pacientes com piomiosite tropical, com apenas um caso descrito na literatura mundial, destacando a necessidade dos métodos complementares na investigação diagnóstica para o adequado tratamento e as possíveis complicações dessa doença. Os pacientes imunossuprimidos com dores musculares subagudas devem ser investigados quanto à piomiosite tropical e o diagnóstico precoce é fundamental para o sucesso do tratamento.Descritores: Piomiosite; Abscesso epidural; Imunossupressão; Infecções estafilocócicas. RESUMO the pyomyositis is a subacute deep muscle infection that can cause single or multiple intramuscular abscesses and is associated with systemic infections, diabetes mellitus, immunosuppressive therapy, AIDS and multiple myeloma. We describe a case of tropical pyomyositis with spinal involvement evolving to epidural abscess. the patient had a history of ankylosing spondylitis treated with immunosuppressive medications and presented direct injury in the right thigh prior to onset of symptoms. this article describes the unusual involvement of the spine in patients with tropical pyomyositis, with only one case reported in the world literature, highlighting the need for complementary methods of diagnostic investigation, for proper treatment and the possible complications of this disease. In conclusion, immunosuppressed patients with muscle pain should be investigated as to the tropical pyomyositis and the early diagnosis is InTROdUÇÃOA piomiosite é uma infecção bacteriana aguda do músculo esquelético que geralmente é causada pelo Staphylococcus aureus. O acúmulo de pus inicialmente é intramuscular e não secundário a infecção adjacente da pele, tecidos moles ou osso. Clinicamente é caracterizado por febre, dor muscular localizada, rigidez e edema 1,2 . Classicamente, a piomiosite é uma infecção dos trópicos, ocorrendo preferencialmente em pacientes jovens do sexo masculino, saudáveis e ativos. Nos países temperados ocorre mais em pacientes imunocomprometidos e debilitados 2 . Pode ser chamada de piomiosite primária, miosite purulenta tropical, miosite bacteriana ou piomiosite tropical. RElATO dE CASOPaciente do sexo masculino, 48 anos de idade, pardo, comerciante, natural do Espírito Santo, portador de espondilite anquilosante, submetido à artroplastia total bilateral dos quadris há 15 anos, procurou o Serviço de Ortopedia e Traumatologia queixando-se de

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Primary erector spinae pyomyositis causing an epidural abscess: case report and literature review

Cited by 18 publications

References 15 publications

Magnetic Resonance Imaging of Dermatomyositis with Bilateral Involvement of the Erector Spinae Muscle

Magnetic Resonance Imaging of Dermatomyositis with Bilateral Involvement of the Erector Spinae Muscle

Pyogenic Epidural Abscess with Primary Erector Spinae Pyomyositis - Case Report~!2010-04-29~!2010-05-23~!2010-08-02~!

Abscesso epidural em paciente portador de piomiosite tropical: relato de caso e revisão da literatura

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