Obturator internus pyomyositis is a rare disease that is more commonly found in tropical countries. Due to its infrequent occurrence, it is a differential of hip pain that has not been sufficiently considered, which often results in delayed diagnosis. We present a case report of a 4 year old boy with pyomyositis of obturator internus as well as externus. He was treated successfully with intravenous antibiotics. A comparison is made with other case reviews to identify symptoms and signs that could help in diagnosing the condition early and accurately so as to initiate intravenous antibiotics, the mainstay treatment in a timely fashion, eventually avoiding surgical drainage of the sequelae when it becomes an abscess.
Pyomyositis

No abstract available.
Hip* ; Pyomyositis*

The diagnosis of pyomyositis in the pelvic region is difficult, as its incidence is relatively, with symptoms that mimic those of discogenic pain. Sciatica is a common presentation of a prolapsed lumbar disc. Less common causes, such as spinal stenosis, pelvic tumors or even primary nerve tumors can also cause these symptoms. Magnetic resonance imaging (MRI) is a useful diagnostic tool. Herein, the case of a patient with an acute pyogenic infection in the iliopsoas muscle, presenting with sciatica, is reported. This is a rare infective disease, which if promptly treated with intravenous antibiotics, can be completely resolved; otherwise, it can result in deep abscess formation, sepsis and death.
Abscess ; Anti-Bacterial Agents ; Diagnosis ; Humans ; Incidence ; Magnetic Resonance Imaging ; Pelvis ; Pyomyositis* ; Sciatica ; Sepsis ; Spinal Stenosis

Pyomyositis is a bacterial infection of the skeletal muscle with Staphylococcus aureus being the most common pathogen. Pyomyositis by salmonella is quite rare accounting for less than 1% of the total pyomyositis, and has some different characteristics and a poor prognosis compared with those of the typical pyomyositis caused by other bacteria. Among these differences, an older age, other combined diseases, and an immune deficient condition are factors predisposing a patient to pyomyositis by salmonella. We experienced a very rare case of pyomyositis by salmonella at the inguinal area in a multiple myeloma patient. This is the first case reported in South Korea.
Bacteria ; Bacterial Infections ; Humans ; Korea ; Multiple Myeloma* ; Muscle, Skeletal ; Prognosis ; Pyomyositis ; Salmonella* ; Staphylococcus aureus

Pyomysitis is a primary acute bacterial infection of large skeletal muscule, usually occuring in the absence of specific cause of infection. Pyomyositis has been reported mainly in tropical countries and was rare in temperate climates. but it has been recognized with increasing frequency. Toxic shock syndrome(TSS) is an acute mutisystemic disease characterized by high fever, hypotension, multisystem dysfunction and erythematous rash followed by skin desquamation 8-12 days after onset. Especially, TSS and pyomyositis are rare conditions in the pediatric population. We experienced one case in a healthy 13-year-girl who developed pyomyositis of the right ileac and gluteal muscles associated with TSS caused by methicillin resistant Staphylococcus aureus. We reports a case of acute pyomyositis with TSS, in which the diagnosis was difficult because of the relative rare incidence in temperate climates and its vague symptoms. To our knowledge, this is the first reported case of pyomyositis with TSS in Korean pediatric population.
Bacterial Infections ; Climate ; Diagnosis ; Exanthema ; Fever ; Hypotension ; Incidence ; Methicillin Resistance* ; Methicillin* ; Muscles ; Myositis ; Pyomyositis* ; Shock, Septic* ; Skin ; Staphylococcus aureus* ; Staphylococcus*

A case of pyomyositis of right pyriformis and iliacus muscle in a healthy 13 year old male patient is presented and discussed. Pyomyositis is a primary acute bacterial infection of large skeletal muscles, associated with abscess formation. Since pyomyositis has been reported mainly in tropical countries and is rare in temperate climates, the name 'tropical myositis' is often used. Outside the tropics, pyomyositis is often associated with immune compromised state, and vigorous muscle acivity may have a role in some cases of pyomyositis. In this case, thirteen year old healthy boy developed severe right buttock pain after vigorous gymnasium activity and was treated with acutpucture, then showed high fever and aggrevation of pain. This case was thought to be associated muscle injury due to vigorous gymnasium activity and transient bacteremia following cutaneous acupuncture. He was treated with ultrasono guided needle aspiration and parenteral antibiotics successfully.
Abscess ; Acupuncture* ; Adolescent ; Anti-Bacterial Agents ; Bacteremia ; Bacterial Infections ; Buttocks ; Climate ; Fever ; Humans ; Male* ; Muscle, Skeletal ; Needles ; Pyomyositis*

Pyomyositis is an acute, suppurative bacterial infection of striated muscle. It occurs primarily, and not from contiguous infection. It is considered rare in temperate climates. There has been no report of pyomyositis in the Korean dermatologic literature to date. We report a case of pyomyositis which developed in a 53-year-old male. The patient was admitted for the treatment of cutaneous leukocytoclastic vasculitis on his entire body. He was treated with oral corticosteroids for approximately three weeks. The skin condition did show improvement; however, the patient developed a persistent fever and a newly-found mass on the right upper back. The mass was diagnosed as an abscess, replacing the striated muscles of the back by sono-guided needle aspiration. After surgical intervention and IV antibiotic treatment, the symptoms and mass on the back disappeared. We speculate that the underlying skin condition and long-term use of oral corticosteroids predisposed the patient to pyomyositis.
Abscess ; Adrenal Cortex Hormones ; Bacterial Infections ; Climate ; Fever ; Humans ; Male ; Middle Aged ; Muscle, Striated ; Needles ; Pyomyositis* ; Skin ; Vasculitis, Leukocytoclastic, Cutaneous*

Pyomyositis is a primary bacterial infection of skeletal muscle and this is on the increase worldwide among children as well as young adults. We report herein on a case of a 29-year-old male with pyomyositis of the obturator internus. The fact that pyomyositis predominantly affects the muscles of the lower limb and it is confined to the obturator internus muscle has been poorly recognized. CT with an enhancement was an accurate imaging modality to image the obturator internus muscle and to ascertain the diagnosis for this case. The patient was managed with antibiotics and surgical intervention was not necessary. Pyomyositis of the obturator internus muscle needs to be differentiated from septic arthritis of the hip. The present study reports the clinical signs and treatments of pyomyostis and we review the relevant literature.
Adult ; Anti-Bacterial Agents ; Arthritis, Infectious ; Bacterial Infections ; Child ; Hip ; Humans ; Lower Extremity ; Male ; Muscle, Skeletal ; Muscles ; Pyomyositis ; Young Adult

Early diagnosis and treatment of heterotopic ossification (HO) is essential to the prevention of complications. It is difficult to diagnose HO in its initial phase because non-specific clinical manifestations, laboratory findings and imaging findings of immature HO may mimic other diseases such as cellulitis, osteomyelitis, thrombophlebitis, deep vein thrombosis and local infection with abscess. We experienced two cases of HO, which were misdiagnosed as pyomyositis at first by clinical signs and MRI findings indicating the deep infection; the extensive intramuscular ossification appeared later on. We observed an increase of C-reactive protein and creatine kinase followed by the elevation of alkaline phosphatase with abnormal triphasic bone scan. The trajectory of these biomarkers was analyzed to get more insight into the early stages of HO along with the imaging findings. Although our cases cannot be generalized as typical of immature HO, they clearly demonstrate that the change of specific biomarkers with a careful history taking and physical examination should be noted to detect HO as early as possible while avoiding confusion with other mimicking conditions.
Abscess ; Alkaline Phosphatase ; Biomarkers ; C-Reactive Protein ; Cellulitis ; Creatine Kinase ; Early Diagnosis ; Hydrazines ; Ossification, Heterotopic ; Osteomyelitis ; Physical Examination ; Pyomyositis ; Thrombophlebitis ; Venous Thrombosis

PURPOSE: Pyomyositis is a rare disease in temperature climate region. The diagnosis of pyomyositis is often delayed, and pyomyositis is often misdiagnosed in the emergency department. METHODS: The medical records of 11 patients who were diagnosed as having traumatic pyomyositis in the emergency department at Samsung Medical Center in Seoul, Korea, between 2000 and 2006 were reviewed. Their clinical features, such as history, symptoms, clinical findings, duration from onset of symptoms to diagnosis, medical history, laboratory data, results of imaging studies and clinical course were collected. RESULTS: The psoas muscles were most commonly involved. Computer tomography and magnetic resonance imaging aided in accurate diagnosis of the infection and of the extent of involvement. Incision, drainage, and antibiotics therapy eradicated the infectioin in all patients CONCLUSION: Pyomyositis should be a part of the differential diagnosis for patients with traumatic muscle pain. Radiologic evaluation, such as computer tomography and magnetic resonance imaging, must be considered in the diagnosis of traumatic pyomyositis.
Anti-Bacterial Agents ; Climate ; Diagnosis ; Diagnosis, Differential ; Drainage ; Emergencies* ; Emergency Service, Hospital ; Humans ; Korea ; Magnetic Resonance Imaging ; Medical Records ; Myalgia ; Psoas Muscles ; Pyomyositis* ; Rare Diseases ; Seoul