1/211. pyomyositis due to non-haemolytic streptococci.We present a unique case of a multifocal non-tropical pyomyositis due to non-haemolytic streptococci in a 36-y-old woman. The initial infection was in an area of contused muscle in the left anterior thigh and spread to the contralateral femoral and gluteal musculature. There was a previous history of staphylococcus aureus pyomyositis and colitis ulcerosa. The patient was treated successfully with surgical drainage and parenteral antibiotics.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/211. Muscle infections caused by Salmonella species: case report and review.We describe a patient with salmonella pyomyositis and review 30 other cases reported during the past 4 decades. Men outnumbered women by 2.9 to 1, and the median age of the patients was 51 years. Approximately one-half the cases were caused by salmonella enteritidis. Infected vascular aneurysms were observed in seven patients. Prior salmonella infections and local trauma or lesions were common. Diverse underlying conditions, mainly diabetes and human immunodeficiency virus infection, were present in 81% of the patients, and the psoas muscle was involved in 55% of the cases. One-third of the patients died, and relapses were common after a median time of 5 weeks (range, 4.5-27 weeks) in those who survived. Most patients had anemia, and pathogens were recovered from blood samples from two-thirds of the patients. Salmonella should be considered as a causative agent of muscle infections in the appropriate clinical setting, particularly in patients with underlying diseases or preexisting vascular aneurysms.- - - - - - - - - - ranking = 7keywords = infection (Clic here for more details about this article) |
3/211. Unusual case of septic arthritis of the hip: spread from adjacent adductor pyomyositis.Distinguishing intracapsular and extracapsular hip infections may be clinically difficult. Because of this difficulty in diagnosis, the spread of an extracapsular infection into the hip joint may be missed and lead to significant joint destruction. The case of a patient who suffered from the spread of adductor pyomyositis to the hip joint is reported. The delay in diagnosis of an intracapsular hip infection led to significant intra-articular destruction and ultimately necessitated a Girdlestone resection arthroplasty. The patient's hip function was salvaged with a total hip arthroplasty. The presence of an extracapsular hip infection should mandate serial physical examinations and aggressive evaluation to rule out intracapsular spread. A delay in diagnosis of an intracapsular hip infection can lead to catastrophic results.- - - - - - - - - - ranking = 5keywords = infection (Clic here for more details about this article) |
4/211. Benign acute childhood myositis: laboratory and clinical features.BACKGROUND: Benign acute myositis of childhood is a disorder of midchildhood, typically affecting boys. Symptoms include calf pain and difficulty walking after a viral illness. There is an epidemiologic association with influenza. OBJECTIVES: To describe the clinical and laboratory features of benign acute myositis. RESULTS: Thirty-eight children (32 boys, 6 girls) were seen with 41 episodes of myositis between 1978 and 1997. Two were siblings and three had recurrent episodes. Mean age at onset of symptoms was 8.1 years. Children remained ambulant during 33 of 41 episodes. Two characteristic gaits were noted: toe-walking in 13, with a wide-based stiff-legged gait in another 7. Muscle tenderness was isolated to the gastrocnemius-soleus muscles in 82% of episodes. Recovery occurred within 1 week. creatine kinase levels were elevated during all episodes. Viral studies were positive in 10 of 24 episodes, 5 because of influenza B. CONCLUSION: Benign acute myositis is a syndrome of midchildhood that can be differentiated from more serious causes of walking difficulty by the presence of calf tenderness, normal power, intact tendon reflexes, and elevated creatine kinase. The gait patterns noted may minimize power generation of the calf muscles by splinting the ankles. Onset in childhood may reflect an age-related response to viral infection, and occurrence primarily in boys may reflect a genetic predisposition or an as-yet unknown metabolic defect.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
5/211. pyomyositis - clinical and MRI characteristics report of three cases.We report three patients with pyomyositis due to staphylococcus aureus. Magnetic resonance imaging aided in the accurate diagnosis of the infection and of the extent of involvement. Incision, drainage and antibiotic therapy eradicated the infection in all the patients. We suggest clinical or subclinical bacteraemic seeding of the diseased muscle, as the most likely mechanism for pyomyositis.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
6/211. Group A streptococcal myositis.Myositis is a relatively uncommon presentation of group A streptococcal infection. We present a case of a 3-year-old girl with group A streptococcal myositis primarily involving the soleus muscle. magnetic resonance imaging was valuable in localizing the affected muscle and avoiding surgical exploration.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
7/211. hepatitis c virus infection and myositis: a polymerase chain reaction study.Muscle biopsy tissue from a patient with chronic hepatitis, who was hepatitis c virus (HCV) positive and showed slight weakness of the right arm and leg associated with increased serum creatine kinase levels, was studied using immunocytochemical and polymerase chain reaction (PCR) techniques. Muscle biopsy showed changes compatible with an inflammatory myopathy. Immunohistochemical studies included the use of monoclonal antibodies against human T lymphocytes, macrophages, immunoglobulins, major histocompatibility complex class I molecules (MHC-I), and the neoantigens of the terminal C5b-9 complement membrane attack complex (MAC). In addition to confirming the potential importance of cytotoxic T cells and MHC-I antigen expression in inducing muscle pathology, we demonstrated MAC deposition and the presence of HCV-rna in the muscle of our patient, suggesting that direct involvement of the virus leading to complement activation might be important in inducing muscle damage.- - - - - - - - - - ranking = 4keywords = infection (Clic here for more details about this article) |
8/211. pyomyositis after chemotherapy for breast cancer.pyomyositis is a rare complication of chemotherapy. A 47-year-old woman with metastatic breast cancer, in whom pyomyositis developed after chemotherapy, is described. It was difficult to differentiate between pyomyositis and deep venous thrombosis early in her admission. pyomyositis should be considered part of the differential diagnosis of deep venous thrombosis. This infection, after chemotherapy, usually is considered to be caused by neutropenia or immunodeficiency secondary to the cancer, or both. It is postulated that subclinical myopathy, secondary to the malignancy or drugs used in treating the malignancy, or both, may also predispose to pyomyositis.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
9/211. pyomyositis of the thigh due to prevotella melaninogenica.pyomyositis is an uncommon infection in temperate climates, however, it is being more frequently reported among patients with diabetes or malignancy, or those who are immunocompromised. It is predominantly caused by staphylococcus aureus, and rarely by bacteroides species. pyomyositis due to prevotella melaninogenica has not previously been reported. We describe an elderly patient with pyomyositis of the thigh due to P. melaninogenica which was successfully treated by surgical incision and drainage in combination with metronidazole therapy.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
10/211. Two cases of acute myositis associated with influenza a virus infection in the elderly.During the influenza epidemic of 1998-1999, we observed two elderly patients with influenza-like symptoms who had evidence of acute myositis with elevated serum enzymes. Influenza A infection was confirmed serologically in either case. The present cases suggest that it is important to distinguish influenzal myositis from other forms of myopathy in the elderly patients.- - - - - - - - - - ranking = 5keywords = infection (Clic here for more details about this article) |
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