ABSTRACT
La piomiositis tropical es una infección bacteriana, del músculo esquelético, endémica de áreas tropicales. Se caracteriza por la formación de un absceso piógeno que, del 75 al 90 % de los casos, contiene Staphylococcus aureus como agente etiológico. Se describe el caso de una paciente de 19 años de edad, con piomiositis del músculo cuadrado lumbar izquierdo, cuya puerta de entrada fue un tatuaje realizado en el dorso de la mano homolateral. El diagnóstico fue corroborado por ultrasonido y el cultivo de la secreción purulenta. Se le realizó punción y aspiración de la colección, en dos ocasiones, además de tratamiento antibiótico específico; se logró la resolución total del cuadro. Se concluye que se debe sospechar la presencia de la piomiositis tropical, como complicación de los tatuajes, en aquellos pacientes que tras su realización, se presenten con un cuadro febril prolongado, sobre todo en los practicados por personal no profesional.
Tropical pyomyositis is a bacterial infection of the skeletal muscle endemic in tropical areas. It is characterized by the formation of a pyogenic abscess whose etiological agent contains Staphylococcus aureus in 75-90 % of cases. A case is presented of a 19-year-old female patient with pyomyositis of the left quadratus lumborum muscle, whose entrance door was a tattoo performed on the back of her homolateral hand. The diagnosis was confirmed by ultrasonography and culture of the purulent secretion. Puncture and collection aspiration were performed on two occasions, alongside specific antibiotic treatment. Total resolution was achieved. It is concluded that the presence of tropical pyomyositis as a complication of tattoos should be suspected in patients with prolonged fever after being performed a tattoo, especially if it was not performed by professional personnel.
ABSTRACT
JUSTIFICATIVA E OBJETIVOS: A piomiosite tropical é uma infecção bacteriana, supurativa, típica de países tropicais que acomete um ou mais grupos musculares ricamente vascularizados, ocorrendo principalmente em indivíduos com comprometimento imunológico. Os objetivos deste estudo foram correlacionar os achados anatomopatológicos de um paciente submetido à necropsia com alterações encontradas na síndrome metabólica e insuficiência cardíaca por cardiomiopatia hipertrófica, e discutir os aspectos histopatológicos significativos.RELATO DO CASO: Paciente do sexo masculino, 50 anos, hipertenso,diabético, cardiopata, desenvolveu mialgia em região cervical direita associada à febre, hemoptise e dispneia. A necropsia evidenciou miosite purulenta associada a cocos Gram-positivos,corroborando o diagnóstico de piomiosite tropical. CONCLUSÃO: Assim, é importante atentar para quadros de dor e rigidez muscular, acompanhados de febre em pacientes com comorbidades que levem à imunossupressão. O diagnóstico precoce da piomiosite tropical é fundamental para a instituição do tratamento adequado e o controle das complicações.
BACKGROUND AND OBJECTIVES: Tropical pyomiositis is a suppurative bacterial infection, which is typical of tropical countries and affects one or more richly vascularized muscle groups, occurring mainly in immunocompromised individuals. In this article, we make an anatomoclinical correlation of a necropsied patient with alterations seen in metabolic syndrome and heart failure due to hypertrophic cardiomyopathy, showing the importance of these two entities in the predisposition of the muscle infectious process. A histopathological aspect is discussed, which has relation with tropical pyomyositis.CASE REPORT: Male, 50 year-old, hypertensive, diabetic and cardiac patient who developed myalgia in the right cervical region associated with fever, dyspnea and hemoptysis. The autopsy showed purulent myositis, and Gram stain showed Gram-positive cocci, suggesting the diagnosis of tropical pyomyositis.CONCLUSION: It is important to pay attention to pictures of muscular pain and stiffness, accompanied by fever in patients with comorbidities that lead to immunosuppression. Early diagnosis of tropical pyomyositis is essential for appropriate treatment and control of complications.
Subject(s)
Humans , Male , Middle Aged , Cardiomyopathy, Hypertrophic , Metabolic Syndrome , Pyomyositis/diagnosisABSTRACT
Tropical pyomyositis is an inflammatory condition of skeletal muscles, usually associated with infection with microbials. As this disease is quite rare in Thailand, we report here a 20-year-old man, a Burmese immigrant in Bangkok for 5 months, who presented with fever, malaise, luecocytosis, elevated sedimentation rate, anemia and a tender mass on his right back. Ultrasonography revealed a mass with abscess suggested tropical pyomyositis and was confirmed by open surgery. Pus was sterile. After treatment with cloxacillin for 24 days, the abscess healed and the patient was discharged and has been followed for 4 months with no recurrence of pyomyoistis. Tropical pyomyositis should be considered and differentiated from viral infection, osteomyelitis and visceral abscesses in the tropical countries.