The Pediatric infectious disease journal · 2025
Pyomyositis in Children: A 15-year Retrospective Study From a Tertiary Care Pediatric Hospital in Portugal.
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Cadete Vitória, Norte Susana, Arcângelo Joana, Miranda Eduardo, Tavares Delfin, Nunes Beatriz, Gouveia Catarina
Аннотация
BACKGROUND: Pyomyositis is a primary infection of the skeletal muscle, commonly occurring in tropical countries in children. Treatment is still controversial, with antibiotics plus drainage being the main option.
METHODS: Retrospective, unicentric study of pyomyositis in a tertiary care Pediatric Hospital, from January 2008 to December 2022. Predisposing factors, clinical, laboratory and radiological results, treatment and evolution were analyzed.
RESULTS: Twenty-nine patients were identified, 75.9% male, median age of 8 years old (0.8;17). The most common predisposing factors were intense physical activity (37.9%), followed by trauma (31.0%). Pain (100.0%), functional impairment (82.8%) and fever (65.5%) were the most frequent symptoms. The most affected sites were the pelvis (51.6%) and the upper leg (22.6%). Magnetic resonance imaging had 100% sensitivity, whereas 40.7% of ultrasounds were inconclusive. Blood cultures were positive in 40.0% of cases and pus in 33.3%. Methicillin-sensitive Staphylococcus aureus was the most common isolated organism (36.0%). Most patients were treated with intravenous flucloxacillin plus clindamycin (55.2%) for a median of 14 days (7;30) and a median total duration of 29 days (14;72). Drainage was only performed in 20.7% of patients, of which 6/15 were in the suppurative phase. All patients improved without functional impairment at 6-month follow-up.
CONCLUSION: Pyomyositis' symptoms can be nonspecific. Methicillin-sensitive Staphylococcus aureus was the most common isolated organism, and many patients can be treated conservatively, without drainage, even in the suppurative phase.
METHODS: Retrospective, unicentric study of pyomyositis in a tertiary care Pediatric Hospital, from January 2008 to December 2022. Predisposing factors, clinical, laboratory and radiological results, treatment and evolution were analyzed.
RESULTS: Twenty-nine patients were identified, 75.9% male, median age of 8 years old (0.8;17). The most common predisposing factors were intense physical activity (37.9%), followed by trauma (31.0%). Pain (100.0%), functional impairment (82.8%) and fever (65.5%) were the most frequent symptoms. The most affected sites were the pelvis (51.6%) and the upper leg (22.6%). Magnetic resonance imaging had 100% sensitivity, whereas 40.7% of ultrasounds were inconclusive. Blood cultures were positive in 40.0% of cases and pus in 33.3%. Methicillin-sensitive Staphylococcus aureus was the most common isolated organism (36.0%). Most patients were treated with intravenous flucloxacillin plus clindamycin (55.2%) for a median of 14 days (7;30) and a median total duration of 29 days (14;72). Drainage was only performed in 20.7% of patients, of which 6/15 were in the suppurative phase. All patients improved without functional impairment at 6-month follow-up.
CONCLUSION: Pyomyositis' symptoms can be nonspecific. Methicillin-sensitive Staphylococcus aureus was the most common isolated organism, and many patients can be treated conservatively, without drainage, even in the suppurative phase.