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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
"first report"
symptom
achondroplasia
alexander disease
aniridia
cadasil
canavan disease
child syndrome
cohen syndrome
congenital toxoplasmosis
cowden syndrome
cushing syndrome
cutaneous mastocytosis
cystinuria
dedifferentiated liposarcoma
dentinogenesis imperfecta
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
esophageal squamous cell carcinoma
fabry disease
familial mediterranean fever
focal myositis
harlequin ichthyosis
hirschsprung disease
hodgkin lymphoma, classical
holt-oram syndrome
homocystinuria without methylmalonic aciduria
inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
kindler syndrome
krabbe disease
lamellar ichthyosis
liposarcoma
lymphangioleiomyomatosis
monosomy 21
neonatal adrenoleukodystrophy
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
omenn syndrome
pendred syndrome
pleomorphic liposarcoma
primary hyperoxaluria type 1
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
triple a syndrome
typhoid
waldenström macroglobulinemia
werner syndrome
wiskott-aldrich syndrome
x-linked adrenoleukodystrophy
zellweger syndrome
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