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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/09/17 00:55:11」(JST)
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| Pyomyositis |
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Transverse T2 magnetic resonance imaging section through the hip region showing abscess collection in a patient with pyomyositis.
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| Classification and external resources |
| Specialty |
rheumatology |
| ICD-10 |
M60.0 |
| ICD-9-CM |
040.81, 728.0 |
| DiseasesDB |
29474 |
| MeSH |
D052880 |
| Orphanet |
764 |
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[edit on Wikidata]
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Pyomyositis, also known as tropical pyomyositis or myositis tropicans, is a bacterial infection of the skeletal muscles which results in a pus-filled abscess. Pyomyositis is most common in tropical areas but can also occur in temperate zones.
CT with IV contrast showing enlargement and heterogeneous hypodensity in the right pectoralis major muscle. A focal abscess collection with gas within it is present medially. There are enlarged axillary lymph nodes and some extension into the right hemithorax. Note the soft tissue and phlegmon surrounding the right internal mammary artery and vein. The patient was HIV+ and the pyomyositis is believed to be due to direct inoculation of the muscle related to parenteral drug abuse. The patient admitted to being a "pocket shooter"
CT exam showing a multiloculated fluid collection in the left gluteus minimus muscle found to be a staph aureus pyomyositis in a 12-year-old healthy boy.
Axial T1 weighted fat suppressed post IV gadolinium contrast enhanced MRI image showing a mutliloculated bacterial abscess in the left gluteal muscle which grew Staphlococcus Aureus (methicillin sensitive) thought to be due to tropical pyomyositis.
Coronal fat suppressed post contrast image showing a multiloculated bacterial abscess in the left gluteus minimus muscle due to tropical pyomyositis.
Coronal T2 weighted fat suppressed image showing a multiloculated fluid collection in the left gluteal musculature due to tropical pyomositis in a 12-year-old boy.
Epidemiology
Pyomyositis is most often caused by the bacterium Staphylococcus aureus.[1] The infection can affect any skeletal muscle, but most often infects the large muscle groups such as the quadriceps or gluteal muscles.[2][3][4]
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.[5][6] 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 USA300 strain of MRSA.[2][3][4]
Treatment
The abscesses within the muscle must be drained surgically (not all patient require surgery if there is no abscess). Antibiotics are given for a minimum of three weeks to clear the infection.[2]
References
- ^ 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 b c 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 b 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 b 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.
- ^ 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.
- ^ 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.
- Infectious diseases
- Bacterial disease: Proteobacterial G−
- primarily A00–A79, 001–041, 080–109
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| α |
| Rickettsiales |
Rickettsiaceae/
(Rickettsioses) |
| Typhus |
- Rickettsia typhi
- Rickettsia prowazekii
- Epidemic typhus, Brill–Zinsser disease, Flying squirrel typhus
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|
Spotted
fever |
| Tick-borne |
- Rickettsia rickettsii
- Rocky Mountain spotted fever
- Rickettsia conorii
- Rickettsia japonica
- Rickettsia sibirica
- Rickettsia australis
- Rickettsia honei
- Flinders Island spotted fever
- Rickettsia africae
- Rickettsia parkeri
- Rickettsia aeschlimannii
- Rickettsia aeschlimannii infection
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| Mite-borne |
- Rickettsia akari
- Orientia tsutsugamushi
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| Flea-borne |
|
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|
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| Anaplasmataceae |
- Ehrlichiosis: Anaplasma phagocytophilum
- Human granulocytic anaplasmosis, Anaplasmosis
- Ehrlichia chaffeensis
- Human monocytotropic ehrlichiosis
- Ehrlichia ewingii
- Ehrlichiosis ewingii infection
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|
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| Rhizobiales |
| Brucellaceae |
|
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| Bartonellaceae |
- Bartonellosis: Bartonella henselae
- Bartonella quintana
- Either B. henselae or B. quintana
- Bartonella bacilliformis
- Carrion's disease, Verruga peruana
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|
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| β |
| Neisseriales |
| M+ |
- Neisseria meningitidis/meningococcus
- Meningococcal disease, Waterhouse–Friderichsen syndrome, Meningococcal septicaemia
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| M- |
- Neisseria gonorrhoeae/gonococcus
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| ungrouped: |
- Eikenella corrodens/Kingella kingae
- Chromobacterium violaceum
- Chromobacteriosis infection
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|
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| Burkholderiales |
- Burkholderia pseudomallei
- Burkholderia mallei
- Burkholderia cepacia complex
- Bordetella pertussis/Bordetella parapertussis
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| γ |
Enterobacteriales
(OX-) |
| Lac+ |
- Klebsiella pneumoniae
- Rhinoscleroma, Klebsiella pneumonia
- Klebsiella granulomatis
- Klebsiella oxytoca
- Escherichia coli: Enterotoxigenic
- Enteroinvasive
- Enterohemorrhagic
- O157:H7
- O104:H4
- Hemolytic-uremic syndrome
- Enterobacter aerogenes/Enterobacter cloacae
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| Slow/weak |
- Serratia marcescens
- Citrobacter koseri/Citrobacter freundii
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| Lac- |
| H2S+ |
- Salmonella enterica
- Typhoid fever, Paratyphoid fever, Salmonellosis
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| H2S- |
- Shigella dysenteriae/sonnei/flexneri/boydii
- Shigellosis, Bacillary dysentery
- Proteus mirabilis/Proteus vulgaris
- Yersinia pestis
- Yersinia enterocolitica
- Yersinia pseudotuberculosis
- Far East scarlet-like fever
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| Pasteurellales |
| Haemophilus: |
- H. influenzae
- Haemophilus meningitis
- Brazilian purpuric fever
- H. ducreyi
- H. parainfluenzae
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| Pasteurella multocida |
- Pasteurellosis
- Actinobacillus
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| Aggregatibacter actinomycetemcomitans |
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| Legionellales |
- Legionella pneumophila/Legionella longbeachae
- Coxiella burnetii
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| Thiotrichales |
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| Vibrionaceae |
- Vibrio cholerae
- Vibrio vulnificus
- Vibrio parahaemolyticus
- Vibrio alginolyticus
- Plesiomonas shigelloides
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| Pseudomonadales |
- Pseudomonas aeruginosa
- Moraxella catarrhalis
- Acinetobacter baumannii
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| Xanthomonadaceae |
- Stenotrophomonas maltophilia
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| Cardiobacteriaceae |
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| Aeromonadales |
- Aeromonas hydrophila/Aeromonas veronii
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| ε |
| Campylobacterales |
- Campylobacter jejuni
- Campylobacteriosis, Guillain–Barré syndrome
- Helicobacter pylori
- Peptic ulcer, MALT lymphoma, Gastric cancer
- Helicobacter cinaedi
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Myopathy (M60–M63, 728.0–3,8)
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| Pain |
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| Inflammation |
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| Lytic |
- Muscle weakness
- Rhabdomyolysis
- Muscle atrophy/Amyotrophy
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| Other |
- Myositis ossificans
- Fibrodysplasia ossificans progressiva
- Compartment syndrome
- Diastasis of muscle
- Muscle spasm
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UpToDate Contents
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English Journal
- Emergence of Panton-Valentine leukocidin-positive ST59 methicillin-susceptible Staphylococcus aureus with high cytolytic peptide expression in association with community-acquired pediatric osteomyelitis complicated by pulmonary embolism.
- Sawanobori E1, Hung WC2, Takano T3, Hachuda K4, Horiuchi T4, Higuchi W3, Hung WW5, Iwao Y6, Nishiyama A3, Reva I6, Reva G7, Teng LJ8, Yamamoto T9.
- Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi.J Microbiol Immunol Infect.2015 Oct;48(5):565-73. doi: 10.1016/j.jmii.2014.04.015. Epub 2014 Jul 26.
- A 15-year-old boy, who had had a furuncle on his femur, developed femoral pyomyositis and osteomyelitis complicated by septic pulmonary embolism. Panton-Valentine leukocidin-positive (PVL(+)) ST59 methicillin-susceptible Staphylococcus aureus (MSSA) was isolated from pus and blood. Chemotherapy was
- PMID 25070278
- Tuberculous pyomyositis in a rheumatoid arthritis patient treated with anakinra.
- Migkos MP1, Somarakis GA1, Markatseli TE1, Matthaiou M2, Kosta P3, Voulgari PV1, Drosos AA1.
- Clinical and experimental rheumatology.Clin Exp Rheumatol.2015 Sep-Oct;33(5):734-6. Epub 2015 May 1.
- Musculoskeletal tuberculosis (TB) occurs in only 3% of patients with TB while tuberculous pyomyositis is rare. It usually affects immunocompromised or patients with underlying comorbidities. We present a case of tuberculous pyomyositis in a 85-year-old Caucasian patient with rheumatoid arthritis (RA
- PMID 25936426
- Staphylococcus aureus endocarditis and pyomyositis: Rare complications of rotavirus gastroenteritis.
- Aldemir-Kocabaş B1, Karbuz A1, Kara TT1, Çiftçi Ö2, Uçar T2, Fitöz S3, Çiftçi E1, İnce E1.
- Pediatrics international : official journal of the Japan Pediatric Society.Pediatr Int.2015 Aug;57(4):780-2. doi: 10.1111/ped.12649.
- Rotavirus may cause life-threatening complications in untreated patients during the course of gastroenteritis. Electrolyte imbalance, bacteremia and sepsis are the most common complications of rotavirus gastroenteritis (RG). It is believed that translocation of intestinal microorganisms as a result
- PMID 26315203
Japanese Journal
- 臨床研究・症例報告 股関節痛で発症した化膿性内閉鎖筋炎の1歳児例
- 症例報告 A群β溶血性連鎖球菌による骨盤周囲筋膿瘍例
- 日本小児科学会雑誌 = The journal of the Japan Pediatric Society 119(12), 1772-1776, 2015-12
- NAID 40020687351
- 臨床研究・症例報告 大内転筋における化膿性筋炎の1例
Related Links
- Pyomyositis, also known as tropical pyomyositis or myositis tropicans, is a bacterial infection of the skeletal muscles which results in a pus-filled abscess. Pyomyositis is most common in tropical areas but can also occur in temperate zones.
- 24 Jul 2012 ... Pyomyositis is a purulent infection of skeletal muscle that arises from hematogenous spread, usually with abscess formation. The clinical approach to pyomyositis will be reviewed here. Other soft tissue infections such as ...
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