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Primary obturator-muscle pyomyositis in immunocompetent children.
[pyomyositis]
Primary
pyomyositis
in
immunocompetent
children
in
non-tropical
regions
(
countries
with
temperate
climates
)
is
very
uncommon
.
It
is
rarely
found
in
the
intrapelvic
muscles
,
and
even
more
rarely
in
the
obturator
muscles
.
We
try
to
draw
attention
to
the
potential
occurrence
in
these
conditions
.
Five
new
cases
of
primary
obturator-
muscle
pyomyositis
in
immunocompetent
children
aged
between
6
and
11
Â
years
in
a
temperate
climate
are
presented
.
They
present
with
symptoms
as
follows
:
fever
,
pain
(
thigh
,
abdominal
,
inguinal
,
and
/
or
hip
pain
)
,
and
limp
.
Three
of
them
had
no
hip
movement
limitation
.
All
of
them
had
tenderness
in
the
perineum
zone
.
Laboratory
tests
may
reveal
high
erythrocyte
sedimentation
rate
(
ESR
)
and
C-
reactive
protein
(
CRP
)
counts
,
but
depend
on
the
length
of
diagnostic
delay
.
The
evolution
time
oscillated
from
1
to
5
Â
days
.
Fever
and
limp
disappearance
depends
on
the
evolution
time
previous
to
the
onset
of
the
antibiotics
administration
.
In
4
out
of
5
patients
,
Staphylococcus
aureus
was
present
in
the
blood
cultures
.
In
all
cases
of
obturator-
muscle
pyomyositis
,
diagnosis
was
confirmed
using
computed
tomography
(
CT
)
scan
(
one
)
and
/
or
magnetic
resonance
imaging
(
MRI
)
(
four
)
.
Obturator-
muscle
pyomyositis
is
aimed
at
emphasizing
the
diagnostic
difficulties
associated
with
the
condition
,
due
to
its
deep
location
and
to
the
fact
that
the
disease
presents
with
multiple
manifestations
that
may
initially
cause
confusion
,
since
they
mimic
other
conditions
occurring
in
the
abdomen
,
hip
(
septic
arthritis
,
osteomyelitis
)
,
spine
,
etc
.
The
diagnosis
is
only
confirmed
using
CT
scan
and
/
or
MRI
.
In
the
five
patients
with
antibiotics
treatment
,
the
condition
resolves
without
sequelae
,
even
at
long
-term
follow-up
.
Diseases
Validation
Diseases presenting
"osteomyelitis"
symptom
legionellosis
neuralgic amyotrophy
proteus syndrome
pyomyositis
severe combined immunodeficiency
This symptom has already been validated