1/78. Focal myositis presenting with radial nerve palsy.Focal myositis is a rare inflammatory pseudotumor of skeletal muscle which usually has a benign course. We report a 56-year-old woman with a painful mass in the left arm with a radial nerve palsy. magnetic resonance imaging (MRI) of the left arm showed a mass in the triceps muscle that was suggestive of a soft-tissue sarcoma. electromyography showed a severe radial neuropathy involving both motor and sensory axons. An open biopsy showed focal myositis. Treatment with corticosteroids resulted in complete disappearance of the mass clinically and by MRI, without recurrence for more than 2 years. radial nerve function also recovered completely. As a treatable cause of focal neuropathy, focal myositis should be included in the differential diagnosis of a muscle mass.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/78. orbital myositis due to Kawasaki's disease.Kawasaki's disease is an inflammatory syndrome of young children that affects multiple organ systems. The most common ophthalmologic manifestations of Kawasaki's disease are bilateral conjunctival injection and nongranulomatous iridocyclitis. To our knowledge, this patient is the first with Kawasaki's disease to demonstrate extraocular muscle palsy and orbital myositis.- - - - - - - - - - ranking = 0.22879978982393keywords = organ (Clic here for more details about this article) |
3/78. Nodular sarcoid myositis of skeletal muscle diagnosed by fine needle aspiration biopsy. A case report.BACKGROUND: Symptomatic striated muscle involvement in sarcoidosis is rare. Muscle biopsy is usually required for the diagnosis. Fine needle aspiration biopsy (FNAB) has been successfully used in diagnosing soft tissue lesions. To the best of our knowledge, FNAB of sarcoid myositis has not been reported. CASE: A 31-year-old, black female with a history of sarcoidosis presented with an enlarging, painful, left calf mass. Infected thrombi were suspected. FNAB showed numerous loosely arranged epithelioid histiocytes, multinucleated giant cells and skeletal muscle cells. The overall cytologic picture was that of granulomatous myositis. The cytologic features coupled with the patient's history and magnetic resonance imaging findings suggested sarcoid myositis. Subsequent muscle biopsy showing noncaseating granulomata and negative stains for organisms confirmed the diagnosis of nodular sarcoid myositis. CONCLUSION: Nodular sarcoid myositis can be suggested by FNAB cytology in a patient with a past history of sarcoidosis.- - - - - - - - - - ranking = 0.22879978982393keywords = organ (Clic here for more details about this article) |
4/78. Skeletal muscle pathology in 2 siblings infected with toxoplasma gondii.Skeletal muscle can be the site of inflammatory diseases that lead to muscle weakness, pain, and increased myogenic serum enzymes. Most of these inflammatory myopathies are idiopathic. In some cases inflammatory myopathies are due to infectious agents. We describe the pathological aspects of muscle biopsies of 2 Brazilian siblings who acquired toxoplasmosis at the same time and in similar conditions. One developed a tetraplegia that was confirmed to be due to inflammatory myositis due to toxoplasma. The other developed myocarditis, with heart failure, without skeletal muscle weakness. In both cases many toxoplasma organisms were observed in the muscle biopsies, but in case 1 only was there an inflammatory myopathy with myofiber necrosis; the inflammatory cells were predominantly macrophages with some CD4 cells and rare CD20 cells. In case 1, expression of CD54 was observed in many inflammatory cells as well in endothelial cells, but only in endothelial cells in case 2. After treatment with clindamycin and corticosteroids both cases had only partial improvement, case 1 with a residual muscle weakness and case 2 with residual cardiac insufficiency (requiring digoxin). These cases show that the presence of the parasite in myofibers is not enough to induce an inflammatory myositis with muscle cell necrosis. This suggests that immunological disturbances may contribute to the development of inflammatory myositis due to toxoplasma.- - - - - - - - - - ranking = 0.22879978982393keywords = organ (Clic here for more details about this article) |
5/78. Neutrophilic myositis as an extracutaneous manifestation of neutrophilic dermatosis.Neutrophilic dermatoses are characterized histologically by a sterile infiltration of neutrophils throughout the dermis. The condition may affect various internal organs, notably the lungs, the digestive tract, and the joints, whereas muscle impairment is considered to be extremely rare. We describe the case of a patient with pyoderma gangrenosum in whom severe sterile neutrophilic myositis developed as the first manifestation of an acute myelogenous leukemia.- - - - - - - - - - ranking = 0.22879978982393keywords = organ (Clic here for more details about this article) |
6/78. Focal eosinophilic myositis.Idiopathic hypereosinophilic syndrome (HES) is a heterogeneous group of disorders with the common features of prolonged eosinophilia of underdetermined cause and multiple organ system dysfunction. Focal eosinophilic myositis is an uncommon manifestation of HES. We report a case of focal eosinophilic myositis with tender muscle swelling followed by proximal weakness, but without non-systemic symptoms and muscle trophism in the lower limbs. Muscle biopsy specimen showed acute myositis with eosinophil infiltration. Electromyographic features were typical of myositis. The clinical and biochemical response to corticosteroids was excellent, and a relapse that occurred because the steroid dose was not lowered, responded well.- - - - - - - - - - ranking = 0.22879978982393keywords = organ (Clic here for more details about this article) |
7/78. Cranial neuropathy, myeloradiculopathy, and myositis: complications of mycoplasma pneumoniae infection.polymyositis, transverse myelitis, ascending polyneuritis, bilateral optic neuritis, and hearing loss developed in a patient with high complement-fixing antibody titers to mycoplasma pneumoniae. Each of her three children had primary atypical pneumonia with isolation of the organism. The neurologic disturbance is thought to represent a postinfectious complication of M pneumoniae infection.- - - - - - - - - - ranking = 0.22879978982393keywords = organ (Clic here for more details about this article) |
8/78. MRSA pyomyositis complicating sickle cell anaemia.A patient being treated for sickle cell crisis developed swollen, painful, indurated, discoloured thighs after several days in hospital. Imaging revealed the presence of multiple small abscesses in the muscle and methicillin resistant staphylococcus aureus (MRSA) was cultured from aspirated fluid. pyomyositis usually occurs in association with damaged muscle and impaired host defences. Staphylococcus is the most frequent organism involved. It is not a common complication of sickle cell disease, although it may be under diagnosed. Availability of advanced imaging techniques facilitates early diagnosis of pyomyositis.- - - - - - - - - - ranking = 0.22879978982393keywords = organ (Clic here for more details about this article) |
9/78. Severe cellulitis/myositis caused by stenotrophomonas maltophilia.OBJECTIVE: To present a case of cellulitis/myositis due to stenotrophomonas maltophilia in the absence of trauma and to discuss a potentially novel treatment option. CASE SUMMARY: A 57-year-old white man, having undergone an allogeneic bone marrow transplant, developed myositis with S. maltophilia of the left soleus muscle; there had been no trauma. risk factors for infection included neutropenia, prolonged hospitalization and intensive care unit stay, and broad-spectrum antibiotic exposure. The affected area of muscle was resected and the patient successfully treated with trimethoprim/sulfamethoxazole (TMP/SMX), ticarcillin/clavulanate, and aztreonam. DISCUSSION: In severe myositis/cellulitis caused by S. maltophilia, TMP/SMX is considered the drug of choice. However, bacteriostatic agents such as TMP/SMX are less than ideal in neutropenic patients. The combination of ticarcillin/clavulanate plus aztreonam has been shown to improve activity in vitro against this organism compared with TMP/SMX. This is likely due to inhibition of the 2 beta-lactamases this organism produces by clavulanate and aztreonam. In our study of clinical isolates of S. maltophilia, this combination reduced the minimum inhibitory concentration at 90% by 128-fold and was synergistic against 10 of 12 isolates tested in time-kill analysis. CONCLUSIONS: S. maltophilia is emerging as an important pathogen in patients with compromised immunity, leading to severe infections that are difficult to treat. Based on in vitro synergy studied, we recommend considering ticarcillin/clavulanate plus aztreonam as a potential treatment option in immunocompromised patients with S. maltophilia infection.- - - - - - - - - - ranking = 0.45759957964786keywords = organ (Clic here for more details about this article) |
10/78. pyomyositis associated with bacillary angiomatosis in a patient with hiv infection.Bacillary angiomatosis is an opportunistic infection occurring predominantly in patients with hiv infection. The manifestations of this vasculoproliferative disorder vary markedly. Virtually any organ site may be involved, singly or multiply. However cutaneous involvement can be a valuable clue to its diagnosis. We report a case of bacillary angiomatosis in an hiv-infected patient presenting as isolated pyomyositis of the right leg. The rarity of such a presentation and paucity of cutaneous lesions, as in our case, may render timely diagnosis elusive and difficult. Its recognition however, is important since bacillary angiomatosis, if untreated, is potentially fatal.- - - - - - - - - - ranking = 0.22879978982393keywords = organ (Clic here for more details about this article) |
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