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Pyomyositis
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<h2 id="diagnosis">Diagnosis</h2> <p>Diagnosis is done via the following manner: </p> <ul><li>Pus discharge culture and sensitivity</li> <li>X ray of the part to rule out osteomyelitis</li> <li>Creatinine phosphokinase (more than 50,000 units)</li> <li>MRI is useful</li> <li>Ultrasound guided aspiration</li></ul> <h2 id="treatment">Treatment</h2> <p>The abscesses within the muscle must be drained <a href="/facts/Surgery/fG8tWf5Y">surgically</a> (not all patients require surgery if there is no abscess). <a href="/facts/Antibiotics/sF1kIfxg">Antibiotics</a> are given for a minimum of three weeks to clear the infection.<a class="footnote-ref" id="fnref:2" href="#fn:2"><sup>2</sup></a> </p> <h2 id="epidemiology">Epidemiology</h2> <p>Pyomyositis is most often caused by the bacterium <i><a href="/facts/Staphylococcus_aureus/9yDVBMsc">Staphylococcus aureus</a></i>.<a class="footnote-ref" id="fnref:3" href="#fn:3"><sup>3</sup></a> The infection can affect any skeletal muscle, but most often infects the large muscle groups such as the <a href="/facts/Quadriceps/31aXx9sq">quadriceps</a> or <a href="/facts/Gluteal_muscles/GXExQvGC">gluteal muscles</a>.<a class="footnote-ref" id="fnref:4" href="#fn:4"><sup>4</sup></a><a class="footnote-ref" id="fnref:5" href="#fn:5"><sup>5</sup></a><a class="footnote-ref" id="fnref:6" href="#fn:6"><sup>6</sup></a> </p><p>Pyomyositis is mainly a disease of children and was first described by Scriba in 1885. Most patients are aged 2 to 5 years, but infection may occur in any age group.<a class="footnote-ref" id="fnref:7" href="#fn:7"><sup>7</sup></a><a class="footnote-ref" id="fnref:8" href="#fn:8"><sup>8</sup></a> Infection often follows minor trauma and is more common in the tropics, where it accounts for 4% of all hospital admissions. In temperate countries such as the US, pyomyositis was a rare condition (accounting for 1 in 3000 pediatric admissions), but has become more common since the appearance of the <a href="/facts/ST8%3aUSA300/KQ1Q06u1">USA300</a> strain of <a href="/facts/Methicillin-resistant_Staphylococcus_aureus/4DGUo2co">MRSA</a>.<a class="footnote-ref" id="fnref:9" href="#fn:9"><sup>9</sup></a><a class="footnote-ref" id="fnref:10" href="#fn:10"><sup>10</sup></a><a class="footnote-ref" id="fnref:11" href="#fn:11"><sup>11</sup></a> </p><p>Gonococcal pyomyositis is a rare infection caused by <i><a href="/facts/Neisseria_gonorrhoeae/2oq5rccN">Neisseria gonorrhoeae</a></i>.<a class="footnote-ref" id="fnref:12" href="#fn:12"><sup>12</sup></a> </p> <h2 id="additional-images">Additional images</h2> <ul><li>Maravelas R, Melgar TA, Vos D, Lima N, Sadarangani S (2020). "Pyomyositis in the United States 2002-2014". J Infect. 80(5):497-503. doi:10.1016/j.jinf.2020.02.005. <a href="/facts/PMID_(identifier)/JlHAvMHt">PMID</a> <a href="https://pubmed.ncbi.nlm.nih.gov/32147332">32147332</a>.</li></ul> <h2 id="external-links">External links</h2> <h2 id="references">References</h2> <ol> <li id="fn:1"><p>"Primary pyomyositis". UpToDate. Retrieved 6 March 2023. <a href="https://www.uptodate.com/contents/primary-pyomyositis" target="_blank">https://www.uptodate.com/contents/primary-pyomyositis</a> <a href="#fnref:1" class="footnote-back-ref">↩</a></p></li> <li id="fn:2"><p>Pannaraj PS, Hulten KG, Gonzalez BE, Mason EO Jr, Kaplan SL (2006). "Clin Infect Dis". Clinical Infectious Diseases. 43 (8): 953–60. doi:10.1086/507637. PMID 16983604. <a href="https://doi.org/10.1086%2F507637" target="_blank">https://doi.org/10.1086%2F507637</a> <a href="#fnref:2" class="footnote-back-ref">↩</a></p></li> <li id="fn:3"><p>Chauhan S, Jain S, Varma S, Chauhan SS (2004). "Tropical pyomyositis (myositis tropicans): current perspective". Postgrad Med J. 80 (943): 267–70. doi:10.1136/pgmj.2003.009274. PMC 1743005. PMID 15138315. <a href="http://pmj.bmjjournals.com/cgi/pmidlookup?view=long&pmid=15138315" target="_blank">http://pmj.bmjjournals.com/cgi/pmidlookup?view=long&pmid=15138315</a> <a href="#fnref:3" class="footnote-back-ref">↩</a></p></li> <li id="fn:4"><p>Pannaraj PS, Hulten KG, Gonzalez BE, Mason EO Jr, Kaplan SL (2006). "Clin Infect Dis". Clinical Infectious Diseases. 43 (8): 953–60. doi:10.1086/507637. PMID 16983604. <a href="https://doi.org/10.1086%2F507637" target="_blank">https://doi.org/10.1086%2F507637</a> <a href="#fnref:4" class="footnote-back-ref">↩</a></p></li> <li id="fn:5"><p>Ovadia D, Ezra E, Ben-Sira L, et al. (2007). "Primary pyomyositis in children: a retrospective analysis of 11 cases". J Pediatr Orthop B. 16 (2): 153–159. doi:10.1097/BPB.0b013e3280140548. PMID 17273045. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:5" class="footnote-back-ref">↩</a></p></li> <li id="fn:6"><p>Mitsionis GI, Manoudis GN, Lykissas MG, et al. (2009). "Pyomyositis in children: early diagnosis and treatment". J Pediatr Surg. 44 (11): 2173–178. doi:10.1016/j.jpedsurg.2009.02.053. PMID 19944229. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:6" class="footnote-back-ref">↩</a></p></li> <li id="fn:7"><p>Small LN, Ross JJ (2005). "Tropical and temperate pyomyositis". Infect Dis Clin North Am. 19 (4): 981–989. doi:10.1016/j.idc.2005.08.003. PMID 16297743. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:7" class="footnote-back-ref">↩</a></p></li> <li id="fn:8"><p>Taksande A, Vilhekar K, Gupta S (2009). "Primary pyomyositis in a child". Int J Infect Dis. 13 (4): e149 – e151. doi:10.1016/j.ijid.2008.08.013. PMID 19013093. <a href="https://doi.org/10.1016%2Fj.ijid.2008.08.013" target="_blank">https://doi.org/10.1016%2Fj.ijid.2008.08.013</a> <a href="#fnref:8" class="footnote-back-ref">↩</a></p></li> <li id="fn:9"><p>Pannaraj PS, Hulten KG, Gonzalez BE, Mason EO Jr, Kaplan SL (2006). "Clin Infect Dis". Clinical Infectious Diseases. 43 (8): 953–60. doi:10.1086/507637. PMID 16983604. <a href="https://doi.org/10.1086%2F507637" target="_blank">https://doi.org/10.1086%2F507637</a> <a href="#fnref:9" class="footnote-back-ref">↩</a></p></li> <li id="fn:10"><p>Ovadia D, Ezra E, Ben-Sira L, et al. (2007). "Primary pyomyositis in children: a retrospective analysis of 11 cases". J Pediatr Orthop B. 16 (2): 153–159. doi:10.1097/BPB.0b013e3280140548. PMID 17273045. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:10" class="footnote-back-ref">↩</a></p></li> <li id="fn:11"><p>Mitsionis GI, Manoudis GN, Lykissas MG, et al. (2009). "Pyomyositis in children: early diagnosis and treatment". J Pediatr Surg. 44 (11): 2173–178. doi:10.1016/j.jpedsurg.2009.02.053. PMID 19944229. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:11" class="footnote-back-ref">↩</a></p></li> <li id="fn:12"><p>Jensen M (2021). "Neisseria gonorrhoeae pyomyositis complicated by compartment syndrome: A rare manifestation of disseminated gonococcal infection". IDCases. 23: e00985. doi:10.1016/j.idcr.2020.e00985. PMC 7695882. PMID 33294370. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7695882" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7695882</a> <a href="#fnref:12" class="footnote-back-ref">↩</a></p></li> </ol>