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Pyomyositis in the upper Negro river basin, Brazilian Amazonia.
[pyomyositis]
Pyomyositis
remains
poorly
documented
in
tropical
Latin
America
.
We
therefore
performed
a
retrospective
review
of
cases
admitted
to
a
hospital
in
the
upper
Negro
river
basin
during
2002
-
2006
.
Seasonality
was
assessed
by
the
cosinor
model
and
independent
predictors
of
outcome
were
identified
by
logistic
regression
.
Determinants
of
time-
to
-
fever
resolution
were
analysed
using
Cox
regression
.
No
seasonal
trend
was
observed
(
p
=
0
.
284
)
among
82
hospitalised
patients
.
The
disease
predominated
in
young
males
and
the
most
commonly
affected
part
of
the
body
was
the
lower
limb
(
68
[
63
.
5
%
]
out
of
107
lesions
)
.
Staphylococcus
aureus
was
the
only
identified
infecting
organism
(
18
of
20
culture
results
,
90
%
)
.
Complications
occurred
in
17
patients
(
20
.
7
%
)
and
the
case
fatality
rate
was
2
.
4
%
.
Children
were
more
likely
to
present
with
eosinophilia
than
adults
(
OR
=
4
.
20
,
95
%
CI
1
.
08
-
16
.
32
,
p
=
0
.
048
)
,
but
no
other
significant
differences
regarding
clinical
presentation
and
outcomes
were
observed
.
The
time-
to
-
fever
resolution
was
the
only
independent
determinant
of
poor
outcome
(
OR
=
1
.
52
,
95
%
CI
1
.
22
-
1
.
92
,
p
<
0
.
001
)
and
was
significantly
longer
in
patients
treated
with
combined
antibiotic
therapy
than
in
those
treated
with
single
antibiotics
(
HR
=
0
.
523
,
95
%
CI
0
.
296
-
0
.
926
,
p
=
0
.
026
)
.
Further
studies
to
determine
the
best
antibiotic
therapy
modality
for
the
treatment
of
pyomyositis
are
required
.
Diseases
Validation
Diseases presenting
"poor outcome"
symptom
congenital diaphragmatic hernia
dedifferentiated liposarcoma
esophageal carcinoma
junctional epidermolysis bullosa
krabbe disease
liposarcoma
omenn syndrome
pyomyositis
systemic capillary leak syndrome
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