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      Piomiositis tropical, un gran simulador de diagnóstico infrecuente Translated title: Tropical pyomyositis, a great simulator of uncommon diagnosis

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          Abstract

          La piomiositis tropical es una infección que afecta al músculo estriado, principalmente de región pélvica y proximal de muslos. Lo excepcional radica en la colonización del músculo estriado, evidenciándose la práctica de ejercicio extenuante como factor predisponente. El Staphylococcus aureus es el principal agente etiológico. La presentación se caracteriza por fiebre, mialgia y limitación funcional. El tratamiento contempla antibioticoterapia y drenaje quirúrgico. Se trata de escolar masculino, 11 años, quien presenta dolor en región inguinal izquierda, aumento de volumen en muslo ipsilateral, fiebre, limitación funcional. Práctica interdiaria de béisbol. Posición antálgica de muslo izquierdo, signos de flogosis en región inguinal y glútea ipsilateral. Paraclínicos: Leucocitosis, neutrofilia, proteína C reactiva elevada. Resonancia magnética nuclear demuestra colección en músculos pelvitrocantéricos. Se indicó antibioticoterapia con Clindamicina y Cefotaxime. Presenta evolución satisfactoria.

          Translated abstract

          Tropical pyomyositis is an infection that affects the striated muscle, mainly of the pelvic and proximal thighs. Seen more frequently in immunocompetent males between 2-10 years. The uncommon fact is the colonization of striated muscle, with the practice of extenuating exercise, as a predisposing factor. Staphylococcus aureus is the main etiological agent. Clinical presentation is characterized by fever, myalgia and functional limitation. Treatment includes antibiotic therapy and surgical drainage. Clinical case: An 11 year old boy, who presents with pain in the left inguinal region, increased volume of the ipsilateral thigh, fever and functional limitation. The patient usually practiced baseball every other day. Physical examination: Antalgic position of the left thigh, phlogosis in inguinal and gluteal ipsilateral regions. Paraclinics: Leukocytosis, neutrophilia, elevated C-reactive protein. Nuclear magnetic resonance demonstrates collection in pelvitrocanteric muscles. Antibiotic therapy with Clindamycin and Cefotaxime were prescribed with a satisfactory evolution.

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          Tropical Pyomyositis

          Background: Tropical pyomyositis is characterized by suppuration within skeletal muscles, manifesting as single or multiple abscesses. Though primarily a disease of tropics, it is increasingly being reported from temperate regions in immunosuppressed patients. However, India has only few sporadic case reports. Aims: The aim of this study is to evaluate the causative organisms, clinical presentations, diagnostic modalities, treatment protocols and outcome data in tropical pyomyositis patients. Subjects and Methods: The study was carried out in Nilratan Sircar Medical College and Hospital, Kolkata over 3 years (July 2010 to June 2013). A total of 12 patients were diagnosed with tropical pyomyositis (confirmed with aspiration and culture of pus from muscle). All the investigation and treatment data were recorded systematically. Results: The presenting feature was high fever and myalgia in all 12 patients. Quadriceps femoris was the most commonly involved muscle (50%); followed by iliopsoas (25%). Culture of the aspirate showed Staphylococcus aureus in nine patients (75%), Klebsiella pneumonia in one patient (8.33%) and no growth in two patients (16.67%) even after tubercular and fungal culture. Conclusions: Tropical pyomyositis can affect immune-competent individuals. S. aureus is the most commonly cultured organism. Immediate initiation of appropriate antibiotics and surgical debridement are required to avoid complications. The prognosis remains excellent if promptly treated.
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            Primary obturator-muscle pyomyositis in immunocompetent children.

            Primary pyomyositis in immunocompetent children in non-tropical regions (countries with temperate climates) is very uncommon. It is rarely found in the intrapelvic muscles, and even more rarely in the obturator muscles. We try to draw attention to the potential occurrence in these conditions.
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              Piomiositis

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                avpp
                Archivos Venezolanos de Puericultura y Pediatría
                Arch Venez Puer Ped
                Sociedad Venezolana de Puericultura y Pediatría (Caracas, Distrito Capital, Venezuela )
                0004-0649
                March 2017
                : 80
                : 1
                : 23-26
                Affiliations
                [02] orgnameUniversidad Central de Venezuela orgdiv1Escuela de medicina Luis Razetti
                [01] orgnameHospital Universitario de Caracas
                Article
                S0004-06492017000100006
                76108eea-4b23-4073-8a87-203dd6dcb27f

                http://creativecommons.org/licenses/by/4.0/

                History
                : 15 February 2017
                : 20 March 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 12, Pages: 4
                Product

                SciELO Venezuela


                Piomiositis,Staphylococcus aureus,Infección,Pyomyositis,infection

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