Two cases with rare primary pyomyositis

Abstract

Primary pyomyositis is the pyogenic infection of the skeleton muscle. While it is often seen in tropical and subtropical regions, it is rare in temperate regions. In this study, two incidents were discussed. One of them was in the adductor muscle group in left thigh developed due to Staphylococcus aureus, and the other incident was a rarely seen primary pyomyositis localized to the biceps muscle. In the first case, 72-year-old male patient complained that he had mass and pain in his left thigh. The second case, an 11-year-old girl, was consulted to our clinic owing to the pain in her left arm and restriction on her elbow mobility without a trauma history. Findings were evaluated in clinical, laboratory and radiological aspects. In the aspiration of the muscles, yellow purulent fluid was aspired. She was clinically diagnosed with primary pyomyositis. Following the surgical drainage, anti-biotic treatment was started. After the operation, an improvement in the clinical symptoms and laboratory values of the patients were determined.©2008, Firat University, Medical Faculty.

Keywords

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Nadir Görülen Primer Piyomiyozitli İki Olgu

Öz

Primer piyomiyozit iskelet kasının piyojenik enfeksiyonudur. Tropikal ve subtropikal bölgelerde sık görüldüğü halde ılıman iklimli bölgelerde nadirdir. Bu çalışmada, Staphylococcus aureus’a bağlı gelişen sol uylukta adduktor kas grubuna, diğer olguda ise biseps kasına lokalize olan, nadir görülen primer piyomiyozitli iki olgu tartışıldı. İlk olguda; 72 yaşındaki erkek hastanın sol uyluğunda kitle ve ağrı şikayeti mevcuttu. İkinci olgu ise, on bir yaşında kız çocuğu, travma öyküsü olmaksızın, sol kolunda ağrı ve dirseğinde hareket kısıtlılığı nedeniyle ile kliniğimize başvurdu. Olgular klinik, laboratuar ve radyolojik olarak değerlendirildi. Kasların iğne aspirasyonlarında sarı renkli pürülan mayi aspire edildi. Primer piyomiyozit klinik tanısı konuldu. Cerrahi drenaj yapılıp antibiyoterapi başlandı. Ameliyattan sonra, olguların klinik semptomlarında ve laboratuar değerlerinde düzelme tespit edildi.©2008, Fırat Üniversitesi, Tıp Fakültesi

Anahtar Kelimeler

• Primer piyomiyozit, staphylococcus aureus, cerrahi drenaj, antibiyoterapi

Kaynakça

1. Malhotra R, Singh KD, Bhan S, Dave PK. Primary pyogenic abscess of the psoas muscle. J Bone Joint Surg Am. 1992; 74: 278-284.
2. Chiedozi LC. Pyomyositis. Review of 205 cases in 112 patients. Am J Surg. 1979; 137: 255-259.
3. Peckett WR, Butler-Manuel A, Apthorp LA. Pyomyositis of the iliacus muscle in a child. J Bone Joint Surg Br. 2001; 83:103-105.
4. Wysoki MG, Angeid-Backman E, Izes BA. Iliopsoas myositis mimicking appendicitis: MRI diagnosis. Skeletal Radiol. 1997; 26: 316-318.
5. Yousefzadeh DK, Schumann EM, Mulligan GM, Bosworth DE, Young CS, Pringle KC. The role of imaging modalities in diagnosis and management of pyomyositis. Skeletal Radiol. 1982; 8: 285-289.
6. Zissin R, Gayer G, Kots G, Werner M, Shapiro-Feinberg M, Hertz M. Iliopsoas abscess: a report of 24 patients diagnosed by CT. Abdom Imaging. 2001; 26: 533-539.
7. Yuh WT, Schreiber AE, Montgomery WJ, Ehara S. Magnetic resonance imaging of pyomyositis. Skeletal Radiol. 1988; 17: 190-193.
8. Mueller PR, Ferrucci JT Jr, Wittenberg J, Simeone JF, Butch RJ. Iliopsoas abscess: treatment by CT-guided percutaneous catheter drainage. AJR Am J Roentgenol. 1984; 142: 359-362.

9. Harrington P, Scott B, Chetcuti P. Multifocal streptococcal pyomyositis complicated by acute compartment syndrome: case report. J Pediatr Orthop B.2001; 10: 120-122.
10. Lowy FD. Staphylococcus aureus infections. N Engl J Med. 1998; 339: 520-532.
11. Kabul Tarihi:25.03.2008