Pyomyositis in Children
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Primary pyomyositis in children is prevalent in the tropics and increasingly being recognised from temperate regions. Staphylococcus aureus remains the principle causative organism worldwide, while proportion of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is on rise. Commonly involved groups are around the pelvis and lower limbs. Clinical presentation depends on the stage of disease, most commonly a child presenting with limping with fever. Early diagnosis and management are crucial. The investigation of choice is MRI scan. Appropriate antibiotic treatment should be instituted at the earliest opportunity along with drainage. Majority of patients show excellent and complete recovery with no long-term complications once treatment is started early. A high level of awareness and suspicion of this condition is warranted from all paediatric clinicians.
KeywordsPyomyositis Tropical Children Staphylococcus aureus Muscle abscess
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Dr. Hede declares no competing interests.
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- 2.Miyake H. Beitragezurkenntnis der sogenannten myositis infectiosa. Mitt Grenageb Med Chir. 1904;13:155–98.Google Scholar
- 4.••Groose C. Bacterial myositis and pyomyositis. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, editors. Feigin and Cherry’s textbook of pediatric infectious diseases. 7th ed. Philadelphia: Elesvier Saunders; 2014. This article shows us the epidemiology of pyomyositis in world, one of the most useful reviews on pyomyositis published in textbook of pediatric infectious diseases.Google Scholar
- 8.Chauhan S, Kumar R, Singh KK, Chauhan SS. Tropical pyomyositis: a diagnostic dilemma. J Ind Acad Clin Med. 2004;5:52–4.Google Scholar
- 17.Horn CV, Master S. Pyomyositis tropicans in Uganda. E Afr Med J. 1968;45(7):463–71.Google Scholar
- 21.•Pannaraj PS, Hulten KG, Gonzalez BE, Mason Jr EO, Kaplan SL. Infective pyomyositis and myositis in children in the era of community-acquired, methicillin-resistant Staphylococcus aureus infection. Clin Infect Dis. 2006;43:953–60. This article emphasizes the changing epidemiology of causative organisms of tropical pyomyositis.CrossRefPubMedGoogle Scholar
- 22.•Mitchell PD, Hunt DM, Lyall H, Nolam M, et al. Panton-Valentine leukocidin-secreting Staphylococcus aureus causing sever musculoskeletal sepsis in children. A new threat. J Bone Joint Surg (Br). 2007;89:1239–42. This articles shows us the association of PVL genes with pyomyositis.CrossRefGoogle Scholar
- 23.•Yamaguchi T, Nakamura I, Chiba K, Matsumoto T. Epidemiological and microbiological analysis of community-associated methicillin-resistant Staphylococcus aureus strains isolated from a Japanese hospital. Jpn J Infect Dis. 2012;65(2):175–8. This article is one of the biggest reviews on pyomyositis in Japanese population.PubMedGoogle Scholar
- 24.•Lall M, Sahni AK. Prevalence of inducible clindamycin resistance in Staphylococcus aureus isolates from clinical samples. Med J Armed Forces India. 2014;70(1):43–7. This article state the increasing prevalence of clindamycin resistance in staphylococcus aureus.CrossRefPubMedPubMedCentralGoogle Scholar
- 29.•Hadjipavlou M, Butt DA, McAllister J. Primary pyomyositis: an unusual presentation in an older patient with no recognised risk factors. BMJ Case Rep. 2012. doi: 10.1136/bcr.12.2011.5342. This article emphasizes that pyomyositis is possible even in person without any risk factors.PubMedPubMedCentralGoogle Scholar
- 35.Bertrand SL, Lincoln ED, Prohaska MG. Primary pyomyositis of the pelvis in children: a retrospective review of 8 cases. Orthopedics. 2011;34(12):832–40.Google Scholar
- 46.•Vander Have KL, Karmazyn B, Verma M, et al. Community-associated methicillin-resistant Staphylococcus aureus in acute musculoskeletal infection in children: a game changer. J Pediatr Orthop. 2009;29(8):927–31. Article explaining eagle effect in management of staphylococcal infections.CrossRefPubMedGoogle Scholar
- 47.Brickels J, Ben-Sira L, Kessler A, Wientroub S. Primary pyomyositis. J Bone Joint Surg Am. 2002;84:2277–86.Google Scholar