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Pyomyositis M60.0
Synonym(s)
Myositis tropicans; tropical pyomyositis
Definition
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Acute inflammation of the skeletal muscles, occurring mainly in the tropics and subtropics.
Pathogen
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- Staphylococcus aureus, part MRSA.
- Streptococcus pyogenes.
- Mycobacterium tuberculosis.
- Parasites like trypanosomes and filariae.
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Occurrence/Epidemiology
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Preferably occurring in tropics and subtropics.
Etiopathogenesis
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- Mainly injuries of the skin lead to the invasion of germs into the deeper skin layers up to the muscle layer.
- Viral or parasitic infection as well as malnutrition can predispose a pyomyositis.
Abscess formation up to muscle destruction.
Manifestation
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Mainly occurring in children and young, male adults.
Localization
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Mainly gluteal muscles and M. quadriceps are affected. Furthermore, M. erector spinae and the shoulder girdle muscles can be affected.
Clinic
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Rough, red, occasionally overheated or fluctuating, circumscribed indurations or soft tissue swellings that have reached significantly deeper tissue layers. Muscle pain and fever.
Laboratory
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Leukocytosis, mild eosinophilia, BSG and CRP elevation.
Diagnosis
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- Ultrasound and other imaging techniques.
- Aspiration or smear from abscess material for microbiological examination (culture, PCR).
Differential diagnosis
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Complication(s)(associated diseases
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Muscle destruction; sepsis.
Therapy
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- Abscess incision and drainage or generous removal of affected tissue, if necessary under anaesthesia. If necessary reconstruction of destroyed muscle tissue.
- Antibiotic therapy with a penicillinase-resistant penicillin, initially e.g. flucloxacillin or amoxicillin/clavulanic acid or with a cephalosporin (e.g. cefuroxime). Subsequently antibiosis after antibiogram.
- In case of detection of Mycobacterium tuberculosis tuberculostatic therapy.
Literature
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- Chauhan S, Jain S, Varma S, Chauhan S (2004) Tropical pyomyositis (myositis tropicans): current perspective. Postgrade Med J 80: 267-270
- Lederer W (2007) Tropical pyomyositis in children. J Pediatric orthopaedic surgeon B 16: 383
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Outgoing links (8)
Abscess; Amoxicillin/clavulanic acid; Cefuroxime; Cephalosporins; Flucloxacillin; Mrsa; Phlegmons; Tuberculosis cutis luposa;Disclaimer
Please ask your physician for a reliable diagnosis. This website is only meant as a reference.
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Prof. Dr. med. Peter Altmeyer