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A pediatric case of pyomyositis presenting with septic pulmonary emboli
Hasan Yuksel1, Ozge Yilmaz, Sebnem Orguc
1Celal Bayar University, Department of Pediatric Allergy and Pulmonology, Manisa, Turkey.
Insights
This case highlights a rare instance of pyomyositis, a bacterial muscle infection, co-occurring with septic pulmonary emboli in a child. Early diagnosis and treatment are crucial for improving outcomes in such complex pediatric infections.
Area of Science:
- Pediatrics
- Infectious Diseases
- Radiology
Background:
- Pyomyositis, a bacterial skeletal muscle infection, is typically caused by Staphylococcus aureus and predominantly affects children and immunocompromised individuals.
- Prompt diagnosis and management are essential for favorable prognoses in pediatric infectious conditions.
Observation:
- An 8-year-old girl presented with confusion, fever, and right knee swelling post-trauma.
- Imaging revealed potential pulmonary bleeding, later diagnosed as septic pulmonary emboli, and a knee abscess consistent with pyomyositis.
- Blood cultures confirmed Staphylococcus aureus infection.
Findings:
- The case illustrates a rare association between pyomyositis and septic pulmonary emboli in a pediatric patient.
- Magnetic resonance imaging (MRI) confirmed abscess formation in the affected extremity, aligning with pyomyositis progression.
Implications:
- This case underscores the importance of maintaining a high index of suspicion for pyomyositis and septic pulmonary emboli in children presenting with relevant symptoms.
- Early therapeutic intervention in pediatric cases with combined muscle and pulmonary findings can significantly enhance patient prognosis.
Abstract:
Pyomyositis is a suppurative infection of skeletal muscle most commonly caused by Staphylococcus aureus. It is mainly encountered in children and immunocompromised. Eight year old previously healthy girl presented with confusion, fever and swelling of the right knee two days after a trauma. Abdominal ultrasonography and computerized tomography taken upon development of hematemesis revealed no pathology in the abdomen, but potential bleeding sites in lung sections. Thorax CT images were interpreted in favor of septic pulmonary emboli due to the presence of peripheral nodular consolidation areas with central cavitation, mostly pathchy in medial areas. S. aureus was isolated in the blood culture. At the end of third week of hospitalization, gadolinium enhanced contrast MRI of right extremity was taken to evaluate right extremity swelling and revealed abscess formation as expected in the clinical progress of pyomyositis. Pyomyositis and septic pulmonary emboli are a rare association. This case demonstrates that the high index of suspicion in pediatric cases with muscle findings and septic pulmonary findings and early institution of therapy may improve the prognosis.
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