ABSTRACT
La piomiositis tropical difusa primaria es una enfermedad de presentación infrecuente en nuestro medio, con pocos casos asociados a Staphylococcus aureus meticilino resistente, adquirido en la comunidad (MRSA-AC). Se presenta el caso de un paciente de 70 años, con tratamiento irregular para diabetes mellitus tipo 2, que fue hospitalizado por presentar un cuadro de diez días de evolución, con dolor lumbar irradiado a miembro inferior izquierdo, fiebre y flexión forzada de la cadera derecha por dolor a la movilización. El diagnóstico de piomiositis difusa de ambos psoas se realizó con resonancia magnética. Del cultivo de una colección paravertebral posterior se aisló Staphylococcus aureus resistente a oxacilina, penicilina y dicloxacilina.
Diffuse tropical primary pyomyositis is an infrequent entity in our country, with few cases associated to communityacquired Methicillin- resistant Staphylococcus aureus. There are no reported cases of Community-Acquired Methicillin- Resistant Staphylococcus aureus (CA- MRSA) in Peru. We present the case of a 70 year old male with a previous diagnosis of type 2 diabetes mellitus, receiving irregular treatment, who was admitted to the hospital with a history of 10 days of low back pain radiating to the left leg, fever and forced flexion of the right hip due to pain during movement. The diagnosis of diffuse pyomyositis of both psoas muscles was performed with MRI and culture of a posterior paravertebral collection, from which Staphylococcus aureus resistant to oxacillin, penicillin and dicloxacillin was isolated.
Subject(s)
Aged , Humans , Male , Methicillin-Resistant Staphylococcus aureus , Muscular Diseases/diagnosis , Muscular Diseases/microbiology , Psoas Muscles , Pyomyositis/diagnosis , Pyomyositis/microbiology , Staphylococcal Infections/diagnosisABSTRACT
Pyomyositis is an acute bacterial infection of striated muscles. It is common in the tropics but rarely reported from this part of world. A prospective study of tropical pyomyositis was carried out in Surgical Unit II, Punjab Medical College, Faisalabad, Pakistan. We report fifteen patients treated by us over last three years from January 1991 to December 1993. None of the patients was immune compromised. Their age varied from six months to 70 years. We found sonography very helpful in diagnosing pyomyositis. In nine patients staphylococcus aureus was isolated. E.Coli was the causative organism in two patients and in four patients no organism could be cultured from pus. All the patients were treated by open drainage followed by secondary suturing along with antibiotic cover. One patient died because of septicaemia who had multiple muscles involved