Primary pyomyositis of the pelvis in children: A retrospective review of 8 cases

Styles L Bertrand, Eric D. Lincoln, Matthew G. Prohaska

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
JournalOrthopedics
Volume34
Issue number12
DOIs
StatePublished - Dec 1 2011

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Pyomyositis
Pelvis
Articular Range of Motion
Anti-Bacterial Agents
Infectious Arthritis
Acute-Phase Proteins
Gadolinium
Climate
Artificial Respiration
Abscess
Intensive Care Units
Hip
Early Diagnosis
Drainage
Differential Diagnosis
Fever
Magnetic Resonance Imaging
Pain
Muscles

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Primary pyomyositis of the pelvis in children : A retrospective review of 8 cases. / Bertrand, Styles L; Lincoln, Eric D.; Prohaska, Matthew G.

In: Orthopedics, Vol. 34, No. 12, 01.12.2011.

Research output: Contribution to journalArticle

Bertrand, Styles L ; Lincoln, Eric D. ; Prohaska, Matthew G. / Primary pyomyositis of the pelvis in children : A retrospective review of 8 cases. In: Orthopedics. 2011 ; Vol. 34, No. 12.
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