Tag Archive for: Muscle abscess

A Case of Pyomyositis in a Healthy 11-Year Old Boy with Need of Surgical Drainage

Volume 8 | Issue 1 | January-April 2022 | Page: 47-50 | Alina Frolova, Joana Freitas, Rui Martins, Jorge Coutinho

DOI-10.13107/ijpo.2022.v08i01.134


Authors: Alina Frolova MD [1], Joana Freitas MD [1], Rui Martins MD [1], Jorge Coutinho MD [1]

[1] Department of Pediatric Orthopedics, The University Hospital Centre São João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto Portugal.

Address of Correspondence

Dr. Alina Frolova,
Department of Pediatric Orthopedics, The University Hospital Centre São João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto Portugal.
E-mail: alina.frolova.238@gmail.com


Abstract

Pyomyositis is an uncommon clinical entity affecting predominantly pediatric population. It presents with diffuse muscle involvement, mostly in the lower limb, with occasional abscess formation and need of drainage, coupled to an appropriate antibiotic therapy.
In this article we present a case of a previously healthy 11-year old boy with an acute onset of hip pain and fever, as well as elevation in blood leukocyte count and C-reactive protein. Magnetic resonance imaging showed a gadolinium-enhanced oedema of internal obturator, external obturator, adductors and quadratus femoris, with an intra-muscular abscess of external obturator. After two attempted percutaneous drainages the patient progressed to sepsis, with the need of open surgical drainage through transgluteal approach. Concomitantly, a deep venous thrombosis was also diagnosed.
After the appropriate drainage and a prolonged antibiotic regimen, patient’s condition improved, with full recovery and no sequelae.
Keywords: Pyomyositis, External obturator, Muscle abscess, Transgluteal approach


References

1. Maravelas R, Melgar TA, Vos D, Lima N, Sadarangani S. Pyomyositis in the United States 2002-2014. J Infect. 2020 May;80(5):497-503
2. Bickels J, Ben-Sira L, Kessler A, Wientroub S. Primary pyomyositis. J Bone Joint Surg Am. 2002 Dec;84(12):2277-86
3. Moriarty P, Leung C, Walsh M, Nourse C. Increasing pyomyositis presentations among children in Queensland, Australia. Pediatr Infect Dis J. 2015 Jan;34(1):1-4
4. Moriuchi Y, Fuchigami T, Sugiyama C, Takahashi S, Ohashi Y, Yonezawa R, Mizukoshi W, Morioka I. Obturator pyomyositis and labium majus cellulitis: A case report and literature review. SAGE Open Med Case Rep. 2022 Mar 25
5. Kiran M, Mohamed S, Newton A, George H, Garg N, Bruce C. Pelvic pyomyositis in children: changing trends in occurrence and management. Int Orthop. 2018 May;42(5):1143-1147
6. García-Mata S, Hidalgo-Ovejero A, Esparza-Estaun J. Primary obturator-muscle pyomyositis in immunocompetent children. J Child Orthop. 2012 Jul;6(3):205-15
7. Ovadia D, Ezra E, Ben-Sira L, Kessler A, Bickels J, Keret D, Yaniv M, Wientroub S, Lokiec F. Primary pyomyositis in children: a retrospective analysis of 11 cases. J Pediatr Orthop B. 2007 Mar;16(2):153-9
8. Comegna L, Guidone PI, Prezioso G, Franchini S, Petrosino MI, Di Filippo P, Chiarelli F, Mohn A, Rossi N. Pyomyositis is not only a tropical pathology: a case series. J Med Case Rep. 2016 Dec 21;10(1):372
9. Unnikrishnan PN, Perry DC, George H, Bassi R, Bruce CE. Tropical primary pyomyositis in children of the UK: an emerging medical challenge. Int Orthop. 2010 Feb;34(1):109-13
10. Sánchez-Rodríguez HM, Morales-Ávalos R, Rivera-Zarazúa S, Ramírez-Elizondo MT, Hernández-Rodríguez PA, Vílchez-Cavazos F, Peña-Martínez VM. Piomiositis tropical del músculo ilíaco, obturador interno, piriforme y psoas mayor en un paciente inmunocompetente con claudicación [Tropical pyomyositis of the iliacus, obturator internus, piriformis and psoas major muscles in an immunocompetent patient with claudication]. Acta Ortop Mex. 2021 Jan-Feb;35(1):80-84. Spanish.
11. Tawfik D, Hobson WL. Group A Streptococcal Pyomyositis in a Previously Healthy Six-year-old Girl. Cureus. 2018 Feb 8;10(2):e2168
12. Menge TJ, Cole HA, Mignemi ME, Corn WC, Martus JE, Lovejoy SA, Stutz CM, Mencio GA, Schoenecker JG. Medial approach for drainage of the obturator musculature in children. J Pediatr Orthop. 2014 Apr-May;34(3):307-15
13. White S, Stopka S, Nimityongskul P, Jorgensen D. Transgluteal Approach for Drainage of Obturator Internus Abscess in Pediatric Patients. J Pediatr Orthop. 2017 Jan;37(1):e62-e66


How to Cite this Article:  Frolova A, Freitas J, Martins R, Coutinho J | A Case of Pyomyositis in a Healthy 11-Year Old Boy with Need of Surgical Drainage | International Journal of Paediatric Orthopaedics | January-April 2022; 8(1): 47-50.

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