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Lancing of a boil leading to severe invasive methicillin-sensitive Staphylococcus aureus infection in an adolescent.
[pyomyositis]
A
10
-
year
-old
boy
presented
to
the
emergency
department
with
chief
symptoms
of
fever
and
right
leg
pain
for
3
days
.
Also
of
note
,
he
reported
that
he
had
a
boil
on
his
neck
2
weeks
prior
to
admission
.
This
lesion
was
lanced
by
his
mother
with
a
hot
needle
.
An
X-
ray
,
CT
scan
and
MRI
of
the
right
knee
showed
no
evidence
of
osteomyelitis
.
He
was
placed
on
intravenous
vancomycin
for
empiric
treatment
.
Blood
culture
grew
methicillin-susceptible
Staphylococcus
aureus
(
MSSA
)
,
susceptible
to
vancomycin
and
clindamycin
.
He
continued
to
spike
fever
with
the
development
of
erythema
,
and
swelling
of
the
distal
thigh
.
Repeat
MRI
of
the
right
knee
showed
osteomyelitis
and
subperiosteal
abscess
in
the
distal
femur
shaft
with
surrounding
intramuscular
abscesses
and
pyomyositis
.
He
was
taken
to
the
operating
room
where
50
mL
of
fluid
was
drained
from
the
periosteal
abscess
and
a
bone
biopsy
was
obtained
.
Bone
marrow
culture
also
grew
MSSA
,
susceptible
to
clindamycin
.
Diseases
Validation
Diseases presenting
"subperiosteal abscess in the distal femur shaft with surrounding intramuscular abscesses and pyomyositis"
symptom
pyomyositis
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