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
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Diseases presenting "pyogenic muscular tissue infection" symptom

pyomyositis

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