Pyomyositis in children: early diagnosis and treatment

Abstract Purpose This study was conducted to evaluate early diagnosis, clinical course, and treatment outcome in children with pyomyositis. Methods Between 2001 and 2006, 6 children with a mean age of 7.2 years were diagnosed and treated for pyomyositis in our clinic. The most common site of involve...

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Bibliographic Details
Published in:	Journal of pediatric surgery Vol. 44; no. 11; pp. 2173 - 2178
Main Authors:	Mitsionis, Gregory I, Manoudis, Gregory N, Lykissas, Marios G, Sionti, Ioanna, Motsis, Eustathios, Georgoulis, Anastasios D, Berisa, Alexandros E
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-11-2009
Subjects:	Adolescent Age Factors Anti-Bacterial Agents - therapeutic use Cefuroxime - therapeutic use Child Child, Preschool Combined Modality Therapy Dicloxacillin - therapeutic use Drainage - methods Early Diagnosis Female Humans Magnetic Resonance Imaging Male Muscle, Skeletal - pathology Musculoskeletal infection Pediatrics Pyomyositis Pyomyositis - diagnosis Pyomyositis - drug therapy Pyomyositis - therapy Staphylococcal Infections - diagnosis Staphylococcal Infections - drug therapy Staphylococcal Infections - therapy Staphylococcus aureus Staphylococcus aureus - isolation & purification Surgery Treatment Outcome Tropics Vancomycin - therapeutic use Staphylococcus aureus Tropics Musculoskeletal infection Pyomyositis
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Summary:	Abstract Purpose This study was conducted to evaluate early diagnosis, clinical course, and treatment outcome in children with pyomyositis. Methods Between 2001 and 2006, 6 children with a mean age of 7.2 years were diagnosed and treated for pyomyositis in our clinic. The most common site of involvement was the hip and thigh region. All patients underwent early magnetic resonance imaging (MRI) examination that played a significant role in the early diagnosis and management of the disease. Results Staphylococcus aureus was the most common pathogen and was identified in 3 cases. Intravenous antibiotics were administered and were followed by oral agents for an additional period. The duration of therapy ranged from 3 to 6 weeks. No surgical intervention was needed. Magnetic resonance imaging was used to evaluate response to the therapy. Conclusions Although pyomyositis is a rare disease, it should be considered in the differential diagnosis of immediate onset of musculoskeletal pain in children. Early diagnosis and antibiotic treatment are important as major complications such as abscess formation and sepsis can be avoided. Having a high sensitivity to reactive inflammatory changes, MRI is a valuable tool in the armamentarium of the clinician in early diagnosis of pyomyositis.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0022-3468 1531-5037
DOI:	10.1016/j.jpedsurg.2009.02.053