A fatal case of paediatric post-traumatic pyomyositis

Area of Science:

• Pediatric Infectious Diseases
• Forensic Pathology
• Critical Care Medicine

Background:

• Accidental trauma can predispose children to secondary infections.
• Necrotizing pyomyositis is a rare but severe bacterial muscle infection.
• Septic thromboembolism is a life-threatening complication of severe infections.

Observation:

• A 6-year-old girl presented with fever, cough, and constipation post-fall.
• Clinical course rapidly deteriorated with bradycardia, tachypnea, and altered sensorium.
• Despite resuscitation, the patient died approximately 16 hours after emergency department admission.

Findings:

• Autopsy revealed multiple acute pulmonary, cardiac, and renal infarctions.
• Cause of death determined as septic thromboembolism.
• Underlying condition identified as post-traumatic bacterial necrotizing pyomyositis of the ileo-psoas muscle.

Implications:

• Emphasizes the critical need for prompt diagnosis and management of post-traumatic infections in children.
• Highlights the potential for rapid systemic deterioration and fatality from necrotizing pyomyositis.
• Underscores the importance of forensic autopsy in elucidating complex pediatric deaths.