Primary Purulent Infectious Myositis of the Extremities in Children

Purulent infectious myositis, previously known as tropical pyomyositis, is a bacterial disease characterised by abscess formation deep in the extremity muscles, usually seen in the pediatric population. As this disease has been attempted to be defined in a limited number of previous studies in literature, the aim of this study was to present a case series in the light of current diagnostic methods.

A total of 52 children (38 males and 14 females) with a mean age of 9.0±5.30 years were diagnosed with primary purulent infectious myositis with extremity localization and underwent surgical debridement between November 2018 and July 2023. A record was made of demographic data, the time since the onset of symptoms, anatomic localization, laboratory parameters, radiological data, culture results, and complications during follow-up.

The mean time from the onset of symptoms to presentation was 15±5.87 days, and 35 (69%) patients had a history of trauma before the onset of symptoms. The muscle region involved was the lower extremity in 36 (69%) patients and the upper extremity in 16 (31%). After surgical debridement, the duration of hospitalization was a mean of 7±3.30 days, and in 36 (69%) patients, Staphylococcus aureus was identified in the cultures. Full recovery was obtained in 47 (95%) patients, and osteomyelitis developed during the follow-up of 5 (10%) patients.

Purulent infectious myositis is a significant health problem, which is characterized by abscess formation and requires acute intervention. Although magnetic resonance imaging is the most important diagnostic tool, especially in differential diagnosis, when it cannot be performed, the evaluation of the physical examination of the abscess for the surgical decision, combined with laboratory parameters, other radiological methods, needle aspiration, and rapid surgical debridement, can be considered important in the management of the disease.

IV-Retrospective study.