Presentation
Aim: To present the features and management of Pyogenic myositis in children. Method: Two boys of four and six years old presented to our hospital within 6 months. [online.boneandjoint.org.uk]
A rationalisation of the 1350 boxes used throughout the book gives a simpler and clearer presentation of the various categories. [books.google.com]
Therapy is based on the clinical presentation and the underlying pathogen. [scinapse.io]
Aeromonas hydrophila is present in wound drainage and surgical excised tissue and is frequently present in blood cultures obtained on presentation. [infectiousdiseaseadvisor.com]
Muscle edema, characterized by high T2 signal is typically present. Abscesses appear, as elsewhere, as fluid collection (high T2, low T1) with peripheral contrast enhancement. There may also be diffuse muscle enlargement. [radiopaedia.org]
Entire Body System
- High Fever
fever, which suggested bacteremia, as well as muscle damage, including trauma and overuse. [healio.com]
For example, if you are suffering from infectious myositis, you may also experience a high fever, chills, a sore throat, cough, fatigue and a runny nose. [belmarrahealth.com]
After 1–2 weeks, high spiky fever with abscess marks the beginning of the ‘‘suppurative stage’’ followed by the ‘‘late stage’’ defined by bacteremia [ 2 ]. [karger.com]
History goes back to 1 day prior to presentation when he started to present with acute onset sub-umbilical pain, aggravated by activity, and associated with high grade fever (39oC) and chills. [medcraveonline.com]
When infectious myositis is caused by the flu, symptoms include not only muscle aches and muscle weakness, but also high fever, chills, sore throat, cough, fatigue and runny nose. [drugs.com]
- Chronic Infection
Infectious Myositis Infectious myositis is inflammation of the muscles due to an acute, subacute or chronic infection. [healthhype.com]
Therefore, the role of vaccines is increasingly important, as advancing technology has now broadened the targets of vaccination to include a greater number of infectious diseases, tumours, chronic infections, autoimmune diseases and allergies. [mbiotech.org]
Infectious myositis is an acute, subacute, or chronic infection of skeletal muscle. It was considered a tropical disease once but now seen in temperate climates as well, particularly with the emergence of HIV infection. [boneandspine.com]
- Difficulty Walking
Influenza A and B is the most common cause of viral myositis in the United States and the main symptoms include calf pain and difficulty walking. — Healthline This is another good reason why you should get the flu vaccine annually. [understandingmyositis.org]
Symptoms of IBM include: difficulty walking tripping and loss of balance frequent falls trouble rising from a seated position weakened hand grip and diminished hand and finger dexterity difficulty swallowing muscle weakness muscle pain diminished deep [healthline.com]
When a child has benign acute myositis he or she may suddenly complain about having severe pain in the leg and difficulty walking. In most cases the child has recently had a fever and upper respiratory symptoms. [belmarrahealth.com]
- Lower Extremity Pain
No paresis was apparent in either lower extremity; however, he could not sit because of severe pain. [healio.com]
Fungal Myositis Most often seen in severely immunosuppressed patients Clinical presentation is similar to pyomyositis Often present with lower extremity pain and swelling May involve the paraspinal musculature Clinically presents with fever, rash, and [boneandspine.com]
Often present with lower extremity pain and swelling May involve the paraspinal musculature Differential Diagnosis: Acute Inflammatory Demyelinating Polyradiculoneuropathy, Chronic Inflammatory Demyelinating Polyradiculoneuropathy, Femoral Mononeuropathy [pai-india.org]
- Lymphadenopathy
Contamination of the eyes produces unilateral periocular and palpebral edema with conjunctivitis and preauricular lymphadenopathy (Romaña). Extraocular involvement is rare. [pai-india.org]
Respiratoric
- Cough
He also had mild cough that was dry, intermittent, having no diurnal or postural variation. A local practitioner prescribed him oral azithromycin for 2 days. [pai-india.org]
Hackett2, S Welch2 1Department of Paediatrics, University Hospital, Coventry, UK 2Department of Paediatrics, Birmingham Heartlands Hospital, Birmingham, UK Abstract Case history A 13 year old boy of African origin was admitted with an acute onset of fever, cough [adc.bmj.com]
The observed respiratory symptoms were cough (31%), rhinorrhea (23%), and fever (63%), with a mean duration of 4.3 days. [scielo.br]
They were preceded by sore throats, and more recently, by cough or dysuria. During these episodes, creatine kinase (CK) ranged from 89 to 700 U/litre (normal range <175), normal between episodes. [jmedicalcasereports.biomedcentral.com]
Gastrointestinal
- Nausea
Side effects may include hair loss, low blood counts, elevation in liver enzymes, GI problems (i.e nausea, vomiting), and secondary infections. [hss.edu]
[…] inflammatory conditions include: Rash Fatigue Thickening of the skin on the hands Difficulty swallowing Difficulty breathing People with myositis caused by a virus usually have symptoms of a viral infection, such as runny nose, fever, cough and sore throat, or nausea [webmd.com]
~Cousin Jim “I ran out of my nausea medicine and feel terrible. Can you write me a small refill?” [imrespdx.com]
No urinary symptoms, photophobia, nausea, vomiting, diarrhea, seizures, altered sensorium. On examination, his general condition was fair. He was febrile (Axillary temperature 38.5o C. [pai-india.org]
Cardiovascular
- Thrombosis
In four cases there was associated cellulitis, and in one case each,adjacent joint effusion and deep vein thrombosis were seen. After gadolinium infusion, peripheral rim enhancementwas noted in nine cases and heterogeneous enhancement in one. [synapse.koreamed.org]
Differential diagnosis of pyomyositis may include a diverse numberof clinical conditions involving bone (osteomyelitis), joints(septic arthritis), vessels (thrombosis), or muscle (hematoma orstrain). [oneclass.com]
The involved area becomes anesthetic because of thrombosis of the small vessels that supply the superficial nerves. This can antedate the appearance of skin necrosis, and signifies the presence of NF and not simple cellulitis. [anaerobicinfections.blogspot.com]
Infected vascular grafts Devitalized tissue due to arterial insufficiency/graft thrombosis is the focus of this infection. It occurs in patients with failed vascular grafts, especially in diabetic patients. [infectiousdiseaseadvisor.com]
Musculoskeletal
- Leg Pain
You have a muscle that becomes hot, painful, swollen and stiff Your child complains of severe leg pain and has trouble walking Prognosis The outlook varies, depending on the type of myositis. [drugs.com]
In benign acute myositis, a young child suddenly develops severe leg pain and cannot walk normally. These symptoms are dramatic and frightening, but they usually disappear within a few days. [cidpusa.org]
Workup
After all the initial workups and serology were negative, imaging was considered. [mdpi.com]
The inherited disorders are rare and should be considered only if the inpatient workup does not reveal an obvious cause or if the pattern of illness is highly suggestive of an inherited disorder. [clinicaladvisor.com]
Reports indicated that immunocompromised patients should be treated by broad-spectrum antibiotics, for targeting a wide-range of gram-negative and anaerobic pathogens [29] However, Immune workup was not studied in our patient, due to the lack of evidence [medcraveonline.com]
According to Monto et al ., the positive predictive value of typical viral symptoms (as demonstrated in all of our cases) during an influenza epidemic is about 80%. [27] Muscle biopsy is not routinely recommended in the workup of viral myositis as a negative [ruralneuropractice.com]
Serum
- Leukopenia
Investigations Complete blood count revealed thrombocytopenia in 12, leukopenia in 7, leukocytosis in 6, and relative lymphocytosis in 10. Mean serum CK level was 3158.2 IU/L with 3–10 times above ULN in 10 and more than 10 times in 11. [annalsofian.org]
There was significant increase in CPK enzymes (5507 ± 9180 U/L), LDH (827 ± 598 U/L), and AST (199 ± 245 U/L), with a tendency to leukopenia (4590 ± 1420) leukocytes/mm3. [scielo.br]
Evolving leukopenia may be present with delayed or fulminant presentations, particularly in the presence of toxic and/or septic shock. A low hematocrit is commonly present in clostridial myonecrosis due to toxin-mediated hemolysis. [infectiousdiseaseadvisor.com]
Microbiology
- Borrelia Burgdorferi
Lyme myositis may result from direct invasion of muscle by the spirochete Borrelia burgdorferi or by autoimmune mechanisms. [3] Ixodes scapularis (dammini), tick vector for Lyme disease. Courtesy of Centers for Disease Control and Prevention. [emedicine.medscape.com]
Borrelia burgdorferi can be detected Viral myositis Muscle fiber necrosis without inflammatory Viral particles can be identified in muscle fibers under electron microscopy. [boneandspine.com]
Rhabdomyolysis with acute renal failure due to Borrelia burgdorferi. J. Intern. Med. 235:191-192. [PubMed] [Google Scholar] 114. Jeffrey, H. C. 1974. Sarcosporidiosis in man. Trans. R. Soc. Trop. Med. Hyg. 68:17-29. [PubMed] [Google Scholar] 115. [ncbi.nlm.nih.gov]
Other Pathologies
- Lymph Node Hyperplasia
node hyperplasia Multicentric osteolysis-nodulosis-arthropathy spectrum Multicentric osteolysis-nodulosis-arthropathy syndrome Multicentric reticulohistiocytosis Multicystic dysplastic kidney Multicystic mesothelioma Multicystic renal dysplasia Multifocal [orpha.net]
Treatment
In polymicrobial infections, the treatment becomes even more difficult as different microorganisms have such diverse structures that need specific treatment. [microbewiki.kenyon.edu]
The bacterial myositides include: acute suppurative (tropical) myositis: may result from a Staphylococcal infection of a crush injury commoner in tropical climates treatment is by surgical drainage and high dose antibiotics Clostridial myositis: Clostridium [gpnotebook.com]
Some of the familiar, of many, infections which have been connected with causing Myositis are: Staphylococcus aureus (MRSA) Spirochete (Lyme disease) Treatment Treatment of Infectious, Viral, Bacterial, and Fungal Myositis is often dependent upon the [understandingmyositis.org]
Results: Both children settled with antibiotic treatment alone. The bacterial strain in the second case was of a type requiring combination antibiotic therapy for effective treatment. [online.boneandjoint.org.uk]
Prognosis
If a person with dermatomyositis develops cancer, the prognosis may be worse. Medications taken to treat these muscle diseases may cause complications that affect prognosis. [drugs.com]
Treatment and prognosis Depending on the infective agent systemic antibiotics are administered. If an abscess has formed, then it should usually be drained either surgically or percutaneously. [radiopaedia.org]
Concurrent neutropenia, regardless of cause, predisposes to C. septicum bacteremia, which results in a poor prognosis; the prognosis is worse if intravascular hemolysis occurs. [merckmanuals.com]
In most cases, the prognosis following satisfactory drainage is excellent, with little long-term morbidity. [infectiousdiseaseadvisor.com]
Etiology
Bacterial etiologies did not differ significantly between cases of myositis or pyomyositis. [mdedge.com]
The spectrum of acute myopathy includes various etiologies with different pathophysiology. [annalsofian.org]
The diagnosis of myositis is suggested by the clinical picture and radiologic imaging, and the etiologic agent is confirmed by microbiologic or serologic testing. Therapy is based on the clinical presentation and the underlying pathogen. [scinapse.io]
Conclusions Acute symmetrical proximal muscle weakness has varied etiologies. [mdpi.com]
Etiology: • Direct or indirect trauma • Intramuscular injections of infected or necrotizing materials • Part of syndrome in specific diseases including blackleg, foot-and-mouth disease,ephemeral fever • The exact cause of EM is unknown • May be Sarcocystis [veterpedia.net]
Epidemiology
It also addresses the importance of preventing and controlling infectious disease outbreaks with coverage of epidemiology, biosecurity, antimicrobial therapy, and recognizing foreign equine diseases. [books.google.com]
Myositis in Cattle Definition and Epidemiology: An inflammatory condition grossly characterized by focal, green, muscular lesions in clinically healthy cattle. The most affected tissues are striated skeletal muscle, esophagus and heart. [veterpedia.net]
Endomysium - histological slide Epidemiology The condition affects people with African or Caribbean ancestry at almost double the rate that it affects Caucasians. [kenhub.com]
Theodorou DJ, Theodorou SJ, Kakitsubata Y, Sartoris D, Resnick D (2001) Imaging characteristics and epidemiologic features of atypical mycobacterial infections involving the musculoskeletal system. [link.springer.com]
Antibiotics are given for a minimum of three weeks to clear the infection.[1] Epidemiology[edit] Pyomyositis is most often caused by the bacterium Staphylococcus aureus.[2] The infection can affect any skeletal muscle, but most often infects the large [en.wikipedia.org]
Pathophysiology
Pathophysiology On muscle biopsy, the muscle cells show small rimmed vacuoles, and no evidence of inflammation. This separates it from the inflammatory myopathies such as polymyositis and dermatomyositis. [kenhub.com]
Back to Top Pathophysiology Disruption of the structural integrity and metabolic processes of muscle cells can result from genetic abnormalities, toxins, inflammation, infection, and hormonal and electrolyte imbalances. [clevelandclinicmeded.com]
The spectrum of acute myopathy includes various etiologies with different pathophysiology. [annalsofian.org]
Prevention
Ideal for both practitioners and students, this comprehensive resource covers the diagnosis, treatment, and prevention of infectious disease in horses. [books.google.com]
• Prevention and Control is by: o Vaccination of animals with multivalent clostridial vaccine in areas known to have outbreaks of clostridial diseases. o Preventing the occurrence of sarcocystosis in cattle may also help. [veterpedia.net]
[…] infection Prevention is by far the best treatment for infections. [myositis.org]
Courtesy of Centers for Disease Control and Prevention. American trypanosomiasis: The causative organism is a protozoan, Trypanosoma cruzi. [emedicine.medscape.com]