ABSTRACT
Pyomyositis is a term used to denote primary pyogenic infection of a skeletal muscle. It is a rare disease that was first described in immunodeficient patients living in tropical climates. Lately, however, cases involving healthy children have been described in temperate climates. The origin of primary pyomyositis remains unclear, although it is thought to be caused by seeding from transient bacteremia. Onset of disease is insidious, therefore necessitating rapid diagnosis to successfully select appropriate antibiotic therapy and avoid complications. The signs and symptoms of pyomyositis are nonspecific, which highlights the importance of maintaining a broad differential diagnosis including disease entities such as osteomyelitis and septic arthritis. Magnetic resonance imaging is considered the best imaging modality for distinguishing pyomyositis from other potential etiologies. Here, we present two cases of primary pyomyositis of the lower limb muscles in an 8-year-old boy and in an 11-year-old girl.
Subject(s)
Pyomyositis/microbiology , Staphylococcal Infections , Child , Female , Humans , Male , Pyomyositis/diagnosis , Pyomyositis/therapy , Staphylococcal Infections/diagnosis , Staphylococcal Infections/therapySubject(s)
Electric Power Supplies/adverse effects , Esophagus/injuries , Foreign Bodies/diagnosis , Lithium/adverse effects , Child, Preschool , Eating , Endoscopy, Digestive System/methods , Esophagus/surgery , Fever/etiology , Foreign Bodies/surgery , Humans , Male , Neck/diagnostic imaging , Tomography, X-Ray Computed , Torticollis/etiologyABSTRACT
OBJECTIVES: The main objective of this study was to estimate the prevalence of social and psychological problems, risk behaviors, and depression symptoms in a population of adolescents consulting in a Pediatric Emergency Department of a general hospital, and compare these according to the reasons for consulting. METHODS: Observational monocentric study, in the Pediatric Emergency Department of a general hospital in Britany, France, between January and September 2013, using a questionnaire dispensed to 12- to 18-year-old adolescents. The questions covered habits, school, symptoms, risk behaviors, and depression symptoms. Patients were classified into three groups based of the initial aim of the consultation: medical, traumatologic, and acute psychiatric. RESULTS: A total of 379 adolescents, median age: 15 years, were included. Adolescents from the "psychiatric" group resided significantly more often with only one of their parents or in a residential home; they were more often followed by an youth worker and/or a mental health professional such as a psychologist or a psychiatrist; consumed alcohol, cannabis, and/or tobacco more often; they complained more often of headache or abdominal and lumbar pain, dizziness, and sleep disorders; they consumed anxiolytic and hypnotic drugs more often; they ran away more often; and had signs of depression and/or suicidal ideation and behaviors. The prevalence of all these psychosocial and behavioral risks was also high in the two other groups. CONCLUSION: The Pediatric Emergency Department is a good place to detect adolescents with behavioral problems and/or depression symptoms, even if this is not the initial purpose of admission.
