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[Pyomyositis in Zamora]
M Montserrat Chimeno1, A Chocarro, M Arias
1Servicio de Medicina Interna, Hospital Virgen de la Concha, Zamora.
Background:
Pyomyositis is a purulent infection involving the skeletal muscle. Although it was initially described in tropical countries, is it ever more frequently found in warm climates.
Methods:
A review of the clinical histories of the admission of patients in the Internal and Infectious Medicine Units over the period from May 1992 to April 1994 (1818 admissions) was carried out analyzing those in whom the diagnosis was of pyomyositis. This diagnosis was performed by clinical data and radiologic and microbiologic confirmation.
Results:
Five patients diagnosed with pyomyositis were found. Of the five cases, four were men with ages ranging from 27 to 64 years. In most of the cases more than one muscle group was involved and only two cases showed predisposing factors (history of injury and DM). The existence of abscesses was shown by echography in 3 cases and by CAT in 2 cases. Staphylococcus aureus was the most frequently isolated microorganism. The five patients underwent medical treatment and surgical treatment was also performed in 2 achieving satisfactory evolution.
Conclusions:
Imaging techniques (echography and CAT) effectively contribute to the diagnosis of pyomyositis. Medical treatment, associated with surgery in some cases, achieved satisfactory evolution. The incidence of pyomyositis is probably greater than what has been recognized to date.
Insights
Pyomyositis, a bacterial skeletal muscle infection, is increasingly recognized in warmer climates. Early diagnosis with imaging and prompt treatment, including surgery if needed, leads to good outcomes.
Area of Science:
- Infectious Diseases
- Musculoskeletal Infections
Background:
- Pyomyositis is a purulent skeletal muscle infection.
- Initially described in tropical regions, it is increasingly observed in temperate and warm climates.
Observation:
- A retrospective review of 1818 admissions identified five cases of pyomyositis.
- The majority of patients were male, with multiple muscle groups affected.
- Predisposing factors like injury and diabetes mellitus were noted in a minority of cases.
Findings:
- Imaging techniques, including ultrasound (echography) and CT scans (CAT), were crucial for diagnosing abscesses.
- Staphylococcus aureus was the predominant pathogen identified.
- All patients received medical treatment, with two undergoing surgical intervention, resulting in satisfactory recovery.
Implications:
- Diagnostic imaging plays a vital role in identifying pyomyositis.
- Combined medical and surgical management ensures favorable patient outcomes.
- The actual incidence of pyomyositis may be underestimated.