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Tropical primary pyomyositis in children of the UK: an emerging medical challenge

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Abstract

Pyomyositis is a commonly encountered condition in the tropics. It was not described in the UK until 1998. The reason for the increasing incidence is not understood. We sought to identify the experience gained of this condition within a UK paediatric tertiary referral unit. Retrospective review of cases of pyomyositis from our institution since 1998 was undertaken to identify demographics, presentation, diagnosis and management. Thirteen cases were identified. The obturator internus was most commonly affected (62%). Staphylococcus aureus was cultured in nine cases (69%). One diagnostic retroperitoneal exploration was performed and all cases were identified by computed tomography or magnetic resonance imaging. To our knowledge, this is the first UK series of pyomyositis, reflecting its increasing Western incidence. Early diagnosis and treatment with antibiotics is all that is needed in the majority of cases. A greater awareness of this emerging condition is necessary to prevent misdiagnosis and unnecessary surgical intervention by all surgeons.

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References

  1. Brickels J, Ben–Sira L, Kessler A, Wientroub S (2002) Primary pyomyositis. J Bone Joint Surg Am 84-A:2277–2286

    Google Scholar 

  2. Karmazyn B, Kleiman BM, Buckwalter K, Loder RT et al (2006) Acute pyomyositis of the pelvis: the spectrum of clinical presentations and MR findings. Pediatr Radiol 36:338–343

    Article  PubMed  Google Scholar 

  3. Mitchell PD, Hunt DM, Lyall H, Nolan M et al (2007) Panton-Valentine leukocidin-secreting Staphylococcus aureus causing severe musculoskeletal sepsis in children. A new threat. J Bone Joint Surg Br 89:1239–1242

    Article  CAS  PubMed  Google Scholar 

  4. Chiedozi LC (1979) Pyomyositis. Review of 205 cases in 112 patients. Am J Surg 137:255–259

    Article  CAS  PubMed  Google Scholar 

  5. Echeverria P, Vaughn MC (1975) “Tropical pyomyositis.” A diagnostic problem in temperate climates. Am J Dis Child 129:856–857

    CAS  PubMed  Google Scholar 

  6. Goldberg JS, London WL, Nagel DM (1979) Tropical pyomyositis: a case report and review. Pediatrics 63:298–300

    CAS  PubMed  Google Scholar 

  7. Levin MJ, Gardner P, Waldvogel FA (1971) An unusual infection due to staphylococcus aureus. N Engl J Med 284:196–198

    CAS  PubMed  Google Scholar 

  8. Christin L, Sarosi GA (1992) Pyomyositis in North America: case reports and review. Clin Infect Dis 15:668–677

    CAS  PubMed  Google Scholar 

  9. Gibson RK, Rosenthal SJ, Luckert BP (1984) Pyomyositis. Increasing recognition in temperate climates. Am J Med 77:768–772

    Article  CAS  PubMed  Google Scholar 

  10. Hall RI, Callaghan JJ, Moloney E et al (1990) Pyomyositis in a temperate climate. Presentation, diagnosis, and treatment. J Bone Joint Surg Am 72:1240–1244

    CAS  PubMed  Google Scholar 

  11. Spiegel DA, Meyer JS, Dormans JP et al (1999) Pyomyositis in children and adolescents: report of 12 cases and review of the literature. J Pediatr Orthop 19:143–150

    Article  CAS  PubMed  Google Scholar 

  12. Viani RM, Bromberg K, Bradley JS (1999) Obturator internus muscle abscess in children: report of seven cases and review. Clin Infect Dis 28:117–122

    Article  CAS  PubMed  Google Scholar 

  13. Sirinavin S, McCracken GH Jr (1979) Primary suppurative myositis in children. Am J Dis Child 133:263–265

    CAS  PubMed  Google Scholar 

  14. King RJ, Laugharne D, Kerslake RW et al (2003) Primary obturator pyomyositis: a diagnostic challenge. J Bone Joint Surg Br 85:895–898

    CAS  PubMed  Google Scholar 

  15. Brown JD, Wheeler B (1984) Pyomyositis. Report of 18 cases in Hawaii. Arch Intern Med 144:1749–1751

    Article  CAS  PubMed  Google Scholar 

  16. Andrew JC, Czyz WM (1988) Pyomyositis presenting as septic arthritis. A report of 2 cases. Acta Orthop Scand 59:587–588

    Article  CAS  PubMed  Google Scholar 

  17. Gubbay AJ, Isaacs D (2000) Pyomyositis in children. Pediatr Infect Dis J 19:1009–1013

    Article  CAS  PubMed  Google Scholar 

  18. Zimbelman J, Palmer A, Todd J (1999) Improved outcome of clindamycin compared with beta–lactam antibiotic treatment for invasive Streptococcus pyogenes infection. Pediatr Infect Dis J 18:1096–1100

    Article  CAS  PubMed  Google Scholar 

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Correspondence to P. Nithin Unnikrishnan.

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Unnikrishnan, P.N., Perry, D.C., George, H. et al. Tropical primary pyomyositis in children of the UK: an emerging medical challenge. International Orthopaedics (SICOT) 34, 109–113 (2010). https://doi.org/10.1007/s00264-009-0765-6

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  • DOI: https://doi.org/10.1007/s00264-009-0765-6

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