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Increasing Pyomyositis Presentations among Children in Queensland, Australia.
[pyomyositis]
Pyomyositis
,
usually
associated
with
tropical
climates
,
occurs
less
commonly
in
temperate
regions
and
is
most
often
caused
by
Staphylococcus
aureus
.
Several
community-acquired
methicillin-resistant
Staphylococcus
aureus
(
CA
-MRSA
)
clones
have
emerged
in
Queensland
since
the
beginning
of
the
century
and
they
now
account
for
a
significant
proportion
of
invasive
staphylococcal
infection
.
This
study
aims
to
describe
trends
the
in
rate
of
presentation
,
and
the
clinical
and
diagnostic
features
of
pyomyositis
,
and
to
determine
if
trends
are
attributed
to
the
emergence
of
CA
-MRSA
or
other
factors
.
A
10
-
year
retrospective
cohort
study
of
all
patients
presenting
to
Mater
Children
's
Hospital
in
Brisbane
,
Queensland
,
with
pyomyositis
between
July
2002
and
July
2012
,
was
conducted
.
Data
were
collected
for
clinical
features
,
microbiology
,
diagnostic
tests
,
management
and
outcome
.
Trends
in
incidence
,
and
clinical
and
diagnostic
features
of
pyomyositis
were
analyzed
.
34
cases
of
pyomyositis
were
identified
.
There
was
a
male
predominance
(
79
%
)
and
the
vertebro-
pelvic
muscles
were
most
often
affected
.
The
rate
of
pyomyositis
increased
significantly
during
the
study
period
from
a
rate
of
2
.
04
cases
per
10
,
000
emergency
department
(
ED
)
admissions
in
the
first
quarter
of
the
study
,
to
8
.
73
cases
per
10
,
000
the
final
quarter
(
peak
rate
13
.
5
cases
per
10
,
000
in
2008
)
.
A
causative
organism
was
identified
in
22
cases
,
most
commonly
methicillin-susceptible
Staphylococcus
aureus
(
MSSA
)
(
16
)
with
CA
-MRSA
identified
in
4
cases
.
Patients
who
required
surgical
intervention
had
longer
hospital
admission
,
longer
time
to
resolution
of
inflammatory
markers
,
and
a
higher
risk
of
complication
at
follow-up
.
This
study
demonstrates
an
increasing
incidence
of
pyomyositis
in
a
temperate
region
,
which
is
not
attributable
to
the
emergence
of
CA
-MRSA
.
The
reasons
for
this
change
in
incidence
are
not
clear
.
Diseases
Validation
Diseases presenting
"pelvic muscles"
symptom
pyomyositis
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