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Streptococcal pyomyositis: case report and review
D S Wheeler1, W D Vazquez, K K Vaux
1Department of Pediatrics, Naval Medical Center, San Diego, California 92134-5000, USA.
Insights
Group A beta-hemolytic streptococcus caused chest wall pyomyositis in a child presenting with abdominal pain, without trauma. This unusual case highlights a rare presentation of streptococcal pyomyositis.
Area of Science:
- Pediatric infectious diseases
- Musculoskeletal infections
- Bacterial pathogenesis
Background:
- Pyomyositis, a bacterial muscle infection, is typically linked to Staphylococcus aureus and often follows trauma.
- Group A beta-hemolytic streptococcus (GABHS) is a common pathogen but rarely causes pyomyositis, especially in children.
- Chest wall involvement in pyomyositis is uncommon.
Observation:
- A 15-month-old child presented with acute abdominal symptoms and chest wall pyomyositis.
- The child had no history or physical evidence of trauma to the affected chest wall area.
- Cultures revealed infection with group A beta-hemolytic streptococcus.
Findings:
- This case represents an unusual presentation of pyomyositis secondary to GABHS infection.
- The absence of trauma and primary varicella infection makes this presentation particularly rare.
- The abdominal symptoms may have masked or been associated with the primary source of infection.
Implications:
- Highlights the importance of considering GABHS as a cause of pyomyositis, even without typical risk factors.
- Suggests that pyomyositis can present with atypical symptoms like acute abdominal pain in children.
- Underscores the need for thorough diagnostic evaluation in pediatric patients with unusual presentations of infectious diseases.
Abstract:
Pyomyositis is most often associated with Staphylococcus aureus infections after trauma. We describe an unusual presentation of pyomyositis of the chest wall secondary to group A betahemolytic streptococcus infection in a 15-month-old child with acute abdominal symptoms. In addition, the patient had no history or evidence of trauma to the affected area. Pyomyositis presenting in this manner secondary to group A beta-hemolytic streptococcus infection in the absence of a primary varicella infection has not been previously reported.