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Primary pyomyositis of the pelvis in children: a retrospective review of 8 cases.
[pyomyositis]
Primary
pyomyositis
of
the
pelvic
musculature
is
a
condition
rarely
seen
in
temperate
climates
,
although
its
frequency
has
been
increasing
in
the
United
States
.
The
condition
should
be
considered
in
the
initial
differential
diagnosis
of
an
adolescent
presenting
with
fever
,
difficulty
ambulating
,
and
hip
pain
.
This
is
a
retrospective
review
of
8
cases
of
primary
pelvic
pyomyositis
in
patients
aged
18
years
or
younger
who
were
treated
at
the
Children
's
Medical
Center
in
Augusta
,
Georgia
.
The
site
of
infection
was
the
obturator
internus
in
the
majority
of
the
cases
(
5
)
.
The
site
was
the
gluteus
,
iliopsoas
,
and
iliacus
in
1
case
each
.
Four
patients
who
were
diagnosed
early
responded
to
intravenous
antibiotics
with
no
need
for
further
intervention
.
Two
patients
required
incision
and
drainage
of
an
abscess
combined
with
antibiotics
.
Two
patients
had
prolonged
hospital
courses
requiring
intensive
unit
care
and
mechanical
ventilation
.
Blood
cultures
were
positive
in
87
.
5
%
of
patients
,
and
all
patients
presented
with
elevated
acute
phase
reactants
.
One
of
the
most
difficult
diagnostic
aspects
of
presentation
is
an
inconclusive
symptom
profile
.
It
is
noteworthy
that
patients
with
pelvic
pyomyositis
may
present
with
limited
range
of
motion
in
a
specific
plane
(
the
motion
placing
the
infected
muscle
on
stretch
)
vs
global
limited
range
of
motion
of
the
joint
as
is
commonly
seen
in
septic
arthritis
.
Early
diagnosis
is
essential
to
prevent
systemic
illness
and
complications
associated
with
this
condition
.
Magnetic
resonance
imaging
with
gadolinium
is
helpful
to
diagnose
and
guide
treatment
.
Diseases
Validation
Diseases presenting
"fever"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
alexander disease
allergic bronchopulmonary aspergillosis
canavan disease
carcinoma of the gallbladder
child syndrome
congenital toxoplasmosis
cushing syndrome
cystinuria
dracunculiasis
erdheim-chester disease
esophageal adenocarcinoma
esophageal carcinoma
familial mediterranean fever
focal myositis
hodgkin lymphoma, classical
lamellar ichthyosis
legionellosis
locked-in syndrome
malignant atrophic papulosis
neonatal adrenoleukodystrophy
neuralgic amyotrophy
oculocutaneous albinism
papillon-lefèvre syndrome
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
typhoid
waldenström macroglobulinemia
wolf-hirschhorn syndrome
This symptom has already been validated