Tropical Pyomyositis-an Emerging Multi-Disciplinary Emergency

George, Peter; Bendigeri, Mukhtharahamed

doi:10.4172/2329-9088.1000114

Cited by 3 publications

(6 citation statements)

References 13 publications

(16 reference statements)

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“…They also overlap with symptoms with common endemic febrile diseases, making clinical suspicion often low. Generally, leptospirosis, malaria, dengue, other viral fevers, polymyositis, septic arthritis, osteomyelitis, cellulitis, lymphangitis, deep vein thrombosis should be considered as differential diagnosis [18]. For diagnosis the culture of the abscess or muscle biopsy can be performed [2].…”

Section: Resultsmentioning

confidence: 99%

Tropical Pyomyositis: Case Report

Teixeira¹,

Teixeira²,

Lima³

et al. 2018

Int J Diabetes Clin Res

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Tropical pyomyositis is an infectious disease that affects skeletal muscle and may appear as a diffuse inflammation or a rapidly progressive myonecrotic process. Staphylococcus aureus is the most common microorganism, accounting for 90% of cases. The diagnosis is sometimes late because patients usually do not seek care for the first symptoms, and because it is a rare disease, doctors are still not familiar with the entity. Case report: A 42-year-old male patient with diabetes mellitus, hypothyroidism, anemia, thrombocytopenia, and hypoalbuminemia developed tropical pyomyositis with multiple muscle abscesses, requiring prolonged antibiotic therapy and surgical drainage. Conclusion: Pyomyositis is a little known disease and if not diagnosed early can be fatal. CASe RePoRT Check for updates muscles during transient bacteremia-surgical manipulation of infected oral tissues or even routine dental manipulations, contaminated lower urinary tract catheterization-and it find favorable conditions, as immunosuppression conditions, that trigger infection [2,4,5]. Staphylococcus aureus is the most common microorganism, accounting for 90% of cases. In non-tropical regions, the frequency of staphylococcal infection is lower-about 60% [6]. Tropical pyomyositis is also becoming more common in people infected with HIV. Mechanisms include damage caused by the infection itself, zidovudine therapy, infections caused by parasites and mycobacteria, and deficiency in host defenses [7]. The disease has two peaks of incidence: In childhood (2 to 5 years) and in adulthood (35 to 40 years), 80% male. Non-tropical disease presents a peak of 30-50 and 60-70 years, with a 3:1 ratio [2]. Tropical pyomyositis is not a well-known disease, and its initial characteristics are nonspecific and can be easily confused with other more prevalent pathologies, including arboviruses. The delay in recognition results in a greater number of exams, interventions and days of hospitalization, can generate high costs for the institution; besides negatively influencing the prognosis, the imminent risk of sequelae or death.

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Section: Resultsmentioning

confidence: 99%

Tropical Pyomyositis: Case Report

Teixeira¹,

Teixeira²,

Lima³

et al. 2018

Int J Diabetes Clin Res

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“…7 Although the gold standard for diagnosis is aspiration of pus from the muscle affected. 5 It is usually diagnosed using contrast (gadolinium) MRI, 7 which is the Fig. 1.…”

Section: Discussionmentioning

confidence: 99%

“…7 Treatment recommendation depends on the stage of infection. [1][2][3][4][5] When diagnosed at the early diffuse inflammatory phase these infections respond well to conservative antibiotic treatment 7 and may negate the need for surgical debridement and drainage. 8 Systemic aggressive antibiotic treatment should be continued regardless of surgical input, to prevent further dissemination of the infection until symptoms clear.…”

Section: Discussionmentioning

confidence: 99%

“…6 Surgical drainage can be performed via CT or US guidance. [1][2][3][4][5] Open surgery is reserved for abscess inaccessible to percutaneous drainage. 7 Unfortunately if the infection reaches the extensive muscle necrosis and septic shock phase, management will require surgical drainage, debridement, aggressive antibiotic treatment and intensive care input.…”

Section: Discussionmentioning

confidence: 99%

“…Primary pyomyositis is a rare deep subacute haematogenous intramuscular pyogenic infection of striated skeletal muscle, not secondary to contagious infection from adjacent skin, bone, soft tissue, neighbouring tissue or direct penetrating injury. [1][2][3][4][5][6][7] Pyomyositis is endemically seen in countries with a tropical climate. 3,4 Cases of pyomyositis was seen rarely in temperate countries but has shown an emerging incidence.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Hip adductor pyomyositis from Streptococcus mitis in a four-year-old child

Buldu

Raman

2016

Journal of Clinical Orthopaedics and Trauma

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Tropical pyomyositis as a presenting feature of subclinical leukemia: a case report

et al. 2015

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IntroductionPyomyositis, though classically considered a tropical disease, has a variable geographic prevalence. Among the predisposing risk factors, immunodeficiency plays an important role. Pyomyositis has a tendency to mimic more commonly considered diseases, and a lack of familiarity with it is a cause of delayed diagnosis.Case presentationA 53-year-old South Asian man with newly diagnosed type 2 diabetes mellitus was referred to our medical unit in an advanced stage of the disease, which was complicated by sepsis and acute kidney injury. Failure of the referring unit to provide prompt treatment, as well as their delay in coming to a diagnosis, led to the patient’s complicated state. Antibiotic therapy was initiated, and clinical stabilization was achieved with supportive measures. Following the patient’s recovery from sepsis, his persistent leukopenia and anemia was suggestive of an underlying immunodeficiency, and a subsequent bone marrow biopsy revealed acute myeloid leukemia, M2 variant. Multi-disciplinary care was initiated by the medical, surgical and oncological teams.ConclusionAwareness of tropical pyomyositis is lacking. Common predisposing behaviors and conditions should always be sought and investigated. Immunosuppressive state is an important predisposing factor in the pathogenesis of pyomyositis. Early antibiotic treatment is pivotal in management, and surgical intervention, when relevant, should not be delayed. Identifying one cause should not halt the search for others, as pyomyositis may herald underlying sinister diseases.

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Tropical Pyomyositis-an Emerging Multi-Disciplinary Emergency

Cited by 3 publications

References 13 publications

Tropical Pyomyositis: Case Report

Tropical Pyomyositis: Case Report

Hip adductor pyomyositis from Streptococcus mitis in a four-year-old child

Tropical pyomyositis as a presenting feature of subclinical leukemia: a case report

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