Multifocal pyomyositis associated with hip subluxation in a pediatric patient: a case Report
Article Sidebar
Main Article Content
Abstract
Abstract
Background. Pyomyositis is an acute infection of skeletal muscle, primarily affecting school-aged children, especially those residing in tropical countries. The most isolated pathogen is the methicillin-resistant Staphylococcus aureus (MRSA). Its diagnosis presents a challenge due to the nonspecific clinical presentation that mimics various pathologies. Imaging findings, combined with microbiological isolation, are essential for diagnosis. Case report. Here, we present the case of a 3-year-old child with a diagnosis of hip subluxation related to multifocal pyomyositis of the iliopsoas, gluteus medius, external obturator, internal obturator, and pectineus muscles. Conservative management based on antibiotic therapy was employed as the cornerstone of treatment, resulting in complete resolution of both the clinical and imaging manifestations as demonstrated in the follow-up MRI. Conclusion. Pyomyositis is a common infection in tropical countries, in many cases the clinical picture is non-specific, being a great simulator of other pathologies, which is why it is frequently underdiagnosed. Blood cultures present a low yield in most cases, unlike cultures taken directly from the abscess. Diagnostic suspicion is essential to use the correct antibiotic coverage in a timely manner.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Creative Commons
License Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0)
You are free to:
Share - copy and redistribute the material in any medium or format.
Adapt - remix, transform, and build upon the material The licensor cannot revoke these freedoms as long as you follow the license terms.
• Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
• NonCommercial — You may not use the material for commercial purposes.
• ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
• No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
References
Agarwal V, Chauhan S, Gupta RK. Pyomyositis. Neuroimaging Clin N Am. 2011;21(4):975-x. doi: https://doi.org/10.1016/j.nic.2011.07.011.
Waseem M, Kumari D, Toledano T. Fever and Hip Pain: Not Always Due to a Septic Hip. Pediatr Emerg Care. 2018;34(12):e236-e238. doi: https://doi.org/10.1097/PEC.0000000000000985.
Hassan FO, Shannak A. Primary pyomyositis of the paraspinal muscles: a case report and literature review. Eur Spine J. 2008;17 Suppl 2(Suppl 2):S239-S242. doi: https://doi.org/10.1007/s00586-007-0507-7.
Verma S. Pyomyositis in Children. Curr Infect Dis Rep. 2016;18(4):12. doi: https://doi.org/10.1007/s11908-016-0520-2.
García-Mata S, Hidalgo-Ovejero A, Esparza-Estaun J. Primary obturator-muscle pyomyositis in immunocompetent children. J Child Orthop. 2012;6(3):205-215. doi: https://doi.org/10.1007/s11832-012-0418-y.
Habeych ME, Trinh T, Crum-Cianflone NF. Purulent infectious myositis (formerly tropical pyomyositis). J Neurol Sci. 2020;413:116767. doi: https://doi.org/10.1016/j.jns.2020.116767.
Pérez CA, Rodríguez Y, Moreno S Avilés MJ . . Absceso de músculo iliopsoas y piomiositis extensa en un adolescente inmunocompetente. Revista de Enfermedades Infecciosas en Pediatría. 2013, 26. 270-273.
Pannaraj PS, Hulten KG, Gonzalez BE, Mason EO Jr, Kaplan SL. Infective pyomyositis and myositis in children in the era of community-acquired, methicillin-resistant Staphylococcus aureus infection. Clin Infect Dis. 2006;43(8):953-960. doi: https://doi.org/10.1086/507637.
Mignemi ME, Menge TJ, Cole HA, et al. Epidemiology, diagnosis, and treatment of pericapsular pyomyositis of the hip in children. J Pediatr Orthop. 2014;34(3):316-325. doi: https://doi.org/10.1097/BPO.0000000000000106.
Gamble JG. Primary Psoas Pyomyositis Presenting as Subluxation of the Hip: A Case Report. JBJS Case Connect. 2016;6(1):e21. doi: https://doi.org/10.2106/JBJS.CC.O.00144.
Ropero-Luis G, López-Núñez M, Hidalgo-López C. Multifocal Abdominal Pyomyositis From Subcutaneous Dissemination in an Immunocompetent Patient. Cureus. 2022;14(4): e23766. doi: https://doi.org/10.7759/cureus.23766.
Abbati, G.; Abu Rumeileh, S.; Perrone, A.; Galli, L.; Resti, M.; Trapani, S. Pelvic Pyomyositis in Childhood: Clinical and Radiological Findings in a Tertiary Pediatric Center. Children 2022, 9, 685.
https://doi.org/10.3390/children9050685.
Barchi, L., Fastiggi, M., Bassoli, I. et al. Pyomyositis associated with abscess formation caused by streptococcus pneumoniae in children: a case report and review of literature. Ital J Pediatr 49, 73 (2023). https://doi.org/10.1186/s13052-023-01472-1
Omer Nasiroglu, Sebastian Camargo, Mubin Khan. Pyomyositis resulting in abscess in an infant and in osteomyelitis in a healthy teenager without fever case reports and literature review, Journal of Pediatric Surgery Case Reports, Volume 65, 2021, 101712, ISSN 2213-5766.