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Pyomyositis in childhood: a case report
K L Liew1, C S Choong, P N Liu
1Department of Pediatrics, Jen-Ai General Hospital, Pingtung, Taiwan, ROC.
Insights
A six-year-old experienced pyomyositis, a rare muscle infection, in his lower back. Prompt incision, drainage, and antibiotics led to rapid recovery from the Methicillin-resistant Staphylococcus aureus infection.
Area of Science:
- Pediatric infectious diseases
- Musculoskeletal infections
Background:
- Pyomyositis is a primary skeletal muscle infection, often bacterial.
- It is uncommon in developed countries and typically affects immunocompromised individuals or those with pre-existing conditions.
Observation:
- A previously healthy six-year-old presented with right lower back pain and low-grade fever.
- Imaging revealed multifidus muscle pyomyositis with abscess formation.
Findings:
- Methicillin-resistant Staphylococcus aureus (MRSA) was identified as the causative agent.
- The patient recovered rapidly following incision and drainage with antibiotic therapy.
- Herbal and cold medications may have masked symptoms, delaying diagnosis.
Implications:
- Highlights the importance of considering pyomyositis in pediatric back pain differentials.
- Underscores the potential for non-antibiotic medications to obscure infectious disease presentations.
- Emphasizes the effectiveness of surgical intervention and targeted antibiotics for pyomyositis.
Abstract:
Pyomyositis is a primary infection of skeletal muscle. We report the case of a previously healthy six-year-old who suffered from pyomyositis in the right lower back. He presented with lower back pain and low-grade fever for one week. After a series of laboratory and imaging studies, the diagnosis of right multifidus muscle pyomyositis with abscess formation was made. The patient recovered rapidly after incision and drainage therapy, accompanied by antibiotic treatment. Methicillin-resistant Staphylococcus aureus was cultured from the abscess discharge. It was strongly suspected that herbal medicines and common cold medication the patient had been prescribed before admission to our hospital produced a masking effect that delayed the diagnosis.