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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
"pain"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
adrenomyeloneuropathy
aniridia
aromatase deficiency
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital diaphragmatic hernia
congenital toxoplasmosis
cushing syndrome
cutaneous mastocytosis
cystinuria
dedifferentiated liposarcoma
dentin dysplasia
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
fabry disease
familial mediterranean fever
focal myositis
hirschsprung disease
hodgkin lymphoma, classical
holt-oram syndrome
junctional epidermolysis bullosa
kabuki syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
malignant atrophic papulosis
neuralgic amyotrophy
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
phenylketonuria
pleomorphic liposarcoma
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
scrub typhus
sneddon syndrome
systemic capillary leak syndrome
thoracic outlet syndrome
trochlear dysplasia
typhoid
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
wolf-hirschhorn syndrome
This symptom has already been validated