Tuberculous Pyomyositis of Forearm Muscles

Narang, Sagar

doi:10.1007/s11552-008-9127-x

Cited by 13 publications

(13 citation statements)

References 23 publications

(33 reference statements)

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“…He was asymptomatic when last followed up at 12 months. Successful outcome with nonoperative treatment has been reported [17,20], as in our patient. We believe surgical drainage may be reserved for recalcitrant cases not responding to medical management.…”

Section: Discussion and Treatmentsupporting

confidence: 74%

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Orthopaedic Case of the Month: A 25-Year-Old Man with a Paramedian Painful Lump over the Anterior Chest Wall

Arora

Sural

Dhal

2011

Clinical Orthopaedics &Amp; Related Research

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A 25-year-old Indian man presented with a swelling of 3-weeks duration over the anterior aspect of his left chest (Fig. 1). The swelling was painful and associated with intermittent low-grade fever. It was insidious in onset and gradually progressive in size. There was no history of cough, hemoptysis, recent weight loss, anorexia, pruritus, seizures, or similar swellings elsewhere in the body. The swelling was not associated with any preceding history of trauma. His medical and family histories were noncontributory. The patient had visited a primary care physician who made the provisional diagnosis of muscular cysticercosis and referred the patient to our institution. On examination, the patient's vital signs were stable and there was no evidence of lymphadenopathy. His physical status was good. Local examination revealed a tender 5-cm 9 3-cm hemispheric fluctuant mass located over the left lower chest wall anteriorly near midline. Its margins were not well defined. Local temperature was increased. The overlying skin was freely mobile and there were no scars or sinuses. On attempted contraction of the upper abdominal muscles, there was no change in the size of the swelling; however, its side-to-side mobility became restricted, suggestive of a swelling arising in the muscle. The rest of the organ systems (respiratory system, abdomen, nervous system) appeared normal on clinical examination.Laboratory examination revealed an increased leukocyte count (13,400/mm 3 ) and the differential count was 60 polymorphonuclear leukocytes, 35 lymphocytes, two monocytes, and three eosinophils. The erythrocyte sedimentation rate (53 mm at the end of the first hour) and C-reactive protein (10.3 mg/L) levels were increased. The sputum examination was negative for acid-fast bacilli. Enzyme-linked immunosorbant assay (ELISA) was negative for cysticercosis antibodies. The ELISA test for HIV I and II antibodies was negative. The patient's immune status was normal with no other focus of infection.The patient underwent imaging studies and laboratory tests. Plain radiographs of the chest were normal. Ultrasound, CT, and MRI of the chest were performed.Based on the history, physical examination, and imaging studies, what is the differential diagnosis? Imaging InterpretationUltrasound examination revealed an oval hypoechoic lesion 5 cm 9 3 cm 9 2 cm in the substance of the left rectus abdominis muscle with increased echogenicity of adjacent muscle fibers suggestive of edema; however, there was no evidence of hyperechoic focus (suggestive of calcification or scolex) in the lesion. Doppler examination Each author certifies that he has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Each author certifies that his institution approved the reporting of this case report, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participa...

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Section: Discussion and Treatmentsupporting

confidence: 74%

“…The entity frequently is misdiagnosed as a soft tissue tumor [6,9] or a posttraumatic muscle contusion [17]. Tuberculous pyomyositis occurs more frequently in immunocompromised patients with HIV infection, chronic renal failure, and those receiving cancer chemotherapy or corticosteroids [4,11,14,15,19].…”

Section: Discussion and Treatmentmentioning

confidence: 99%

Orthopaedic Case of the Month: A 25-Year-Old Man with a Paramedian Painful Lump over the Anterior Chest Wall

Arora

Sural

Dhal

2011

Clinical Orthopaedics &Amp; Related Research

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“…Tubercular pyomyositis is commonly misdiagnosed as a soft tissue sarcoma, parasitic infection like cysticercosis or hydatid cyst, and inflammatory myositis or hematoma with secondary infection. 6 Atypical presentation, lack of knowledge about the disease, lack of specific signs and large number of differentials often lead to a delay in diagnosis. Blood investigations usually are normal except a raised ESR which is a consistent finding.…”

Section: Discussionmentioning

confidence: 99%

“…6 Some of the effected muscle groups reported in literature are the forearm muscles, gluteal muscles, rectus abdominis, soleus, temporalis, brachialis and biceps brachii. [6][7][8][9][10][11][12] Tubercular pyomyositis has been reported in immunocompetent as well as in immunodeficient, HIV infected, renal failure patients, patients on corticosteroids, immunosuppressive drugs, or chemotherapy. Tuberculous myositis may mimic malignant or other inflammatory diseases, leading to misdiagnosis.…”

Section: Discussionmentioning

confidence: 99%

Tubercular myositis of infraspinatus: a rare clinical entity

et al. 2016

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“…Isolated involvement of the muscles without skeletal or extraskeletal tuberculosis is believed to be a rare occurrence, although few cases have been reported earlier ( Table 1 ) [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ]. Culotta [ 22 ] reported only four cases of the muscle tuberculosis from autopsies of 2,224 tuberculosis patients.…”

Section: Discussionmentioning

confidence: 99%

Isolated Spontaneous Primary Tubercular Erector Spinae Abscess: A Case Report and Review of Literature

et al. 2015

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Isolated spontaneous primary tubercular erector spinae abscess in an immunocompetent patient is very rare. Here, we report such a case of 21-year-old female, which was successfully managed with timely diagnosis and intervention. Isolated primary tubercular abscess of erector spinae is a rare differential diagnosis of low back pain; however, it must be suspected in an endemic region for tuberculosis, especially when raised erythrocytic sedimentation rate and C-reactive protein are present. Excision along with anti tubercular therapy proved to be a successful strategy in our patient.

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Tuberculous Pyomyositis of Forearm Muscles

Cited by 13 publications

References 23 publications

Orthopaedic Case of the Month: A 25-Year-Old Man with a Paramedian Painful Lump over the Anterior Chest Wall

Orthopaedic Case of the Month: A 25-Year-Old Man with a Paramedian Painful Lump over the Anterior Chest Wall

Tubercular myositis of infraspinatus: a rare clinical entity

Isolated Spontaneous Primary Tubercular Erector Spinae Abscess: A Case Report and Review of Literature

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