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Bilateral hip pain caused by adductor pyomyositis as the initial presentation of chronic myeloid leukemia in a 17-year-old child.
[pyomyositis]
Pyomyositis
is
a
pyogenic
muscular
tissue
infection
mainly
occurring
in
immunocompromised
patients
.
Chronic
myeloid
leukemia
(
CML
)
accounts
for
only
2
-
3
%
of
cases
of
childhood
leukemia
.
Herein
,
we
report
on
a
17
-
year
-old
male
with
bilateral
hip
pain
caused
by
adductor
pyomyositis
before
beginning
the
treatment
course
of
CML
.
CML
was
diagnosed
by
bone
marrow
chromosome
study
and
was
treated
initially
with
imatinib
but
switched
to
hydroxyurea
5
days
later
because
of
poor
cytoreduction
response
.
Subsequently
,
white
blood
cell
counts
decreased
gradually
;
however
,
the
hyperleukocytosis
condition
resolved
very
slowly
again
until
we
switched
back
to
imatinib
use
on
the
40
(
th
)
day
of
hospitalization
.
Pyomyositis
was
diagnosed
by
magnetic
resonance
imaging
.
Oxacillin
was
administered
to
cover
Staphylococcus
aureus
,
the
most
common
pathogen
of
pyomyositis
.
Bilateral
hip
pain
improved
within
72
hours
after
antibiotic
usage
,
but
follow-up
magnetic
resonance
imaging
after
15
days
of
treatment
revealed
well-defined
abscess
and
osteomyelitis
of
both
femoral
heads
.
Abscess
incision
and
drainage
were
performed
,
and
cultures
of
the
drained
pus
grew
no
microorganisms
.
The
patient
completed
5
weeks
of
oxacillin
treatment
after
the
operation
and
recovered
with
a
full
range
of
motion
of
both
hips
.
There
was
no
residual
disability
.
This
is
the
first
report
of
bilateral
hip
pain
caused
by
pyomyositis
as
the
initial
presentation
of
CML
.
Pyomyositis
needs
to
be
considered
in
the
differential
diagnosis
of
hip
pain
in
pediatric
patients
.
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