RESUMEN
Pyomyositis remains poorly documented in tropical Latin America. We therefore performed a retrospective review of cases admitted to a hospital in the upper Negro river basin during 2002-2006. Seasonality was assessed by the cosinor model and independent predictors of outcome were identified by logistic regression. Determinants of time-to-fever resolution were analysed using Cox regression. No seasonal trend was observed (p=0.284) among 82 hospitalised patients. The disease predominated in young males and the most commonly affected part of the body was the lower limb (68 [63.5%] out of 107 lesions). Staphylococcus aureus was the only identified infecting organism (18 of 20 culture results, 90%). Complications occurred in 17 patients (20.7%) and the case fatality rate was 2.4%. Children were more likely to present with eosinophilia than adults (OR= 4.20, 95% CI 1.08-16.32, p=0.048), but no other significant differences regarding clinical presentation and outcomes were observed. The time-to-fever resolution was the only independent determinant of poor outcome (OR=1.52, 95% CI 1.22-1.92, p<0.001) and was significantly longer in patients treated with combined antibiotic therapy than in those treated with single antibiotics (HR=0.523, 95% CI 0.296-0.926, p=0.026). Further studies to determine the best antibiotic therapy modality for the treatment of pyomyositis are required.
Asunto(s)
Anemia/microbiología , Antibacterianos/uso terapéutico , Fiebre/microbiología , Piomiositis/complicaciones , Piomiositis/epidemiología , Infecciones Estafilocócicas/epidemiología , Staphylococcus aureus/patogenicidad , Adolescente , Adulto , Distribución por Edad , Anemia/epidemiología , Anemia/inmunología , Brasil/epidemiología , Niño , Preescolar , Femenino , Fiebre/epidemiología , Fiebre/inmunología , Humanos , Huésped Inmunocomprometido/inmunología , Modelos Logísticos , Masculino , Piomiositis/inmunología , Piomiositis/microbiología , Estudios Retrospectivos , Ríos/microbiología , Estaciones del Año , Distribución por Sexo , Infecciones Estafilocócicas/inmunología , Infecciones Estafilocócicas/microbiología , Factores de Tiempo , Adulto JovenRESUMEN
We report a case of pyomyositis in a 59 year-old immunocompetent male patient caused by methicillin-susceptible Staphylococcus aureus. A CT scan of the chest demonstrated a lesion of the pectoral muscles. The patient was treated with surgical drainage and cephalexin. Pyomyositis is a rare and potentially serious infection that requires early recognition and prompt treatment.
Asunto(s)
Inmunocompetencia , Piomiositis/diagnóstico , Infecciones Estafilocócicas/diagnóstico , Staphylococcus aureus , Humanos , Masculino , Persona de Mediana Edad , Piomiositis/inmunología , Infecciones Estafilocócicas/inmunologíaRESUMEN
We report a case of pyomyositis in a 59 year-old immunocompetent male patient caused by methicillin-susceptible Staphylococcus aureus. A CT scan of the chest demonstrated a lesion of the pectoral muscles. The patient was treated with surgical drainage and cephalexin. Pyomyositis is a rare and potentially serious infection that requires early recognition and prompt treatment.
Se presenta un caso de piomiositis en un varón de 59 años, inmunocompetente, producida por Staphylococcus aureus sensible a meticilina, afectando los músculos pectorales del hemitórax derecho. Fue tratado con drenaje quirúrgico y cefalexina. La piomiositis es una infección infrecuente y potencialmente seria que requiere de un reconocimiento temprano y tratamiento oportuno.