RESUMO
Obturator internal muscle (OIM) abscess or pyomyositis, a poorly recognized intrapelvic infection, is characterized by limping, pain in the hip with limited movement, and the sciatic type of radiating leg pain. With the use of advanced diagnostic tools such as computed tomography (CT), magnetic resonance imaging, and radionuclide scans, several cases of OIM abscess have been diagnosed; these cases have recently been reported in the English-language literature. Staphylococcus aureus is the predominant organism isolated from OIM abscesses. Gonococcal abscess involving the OIM has not been reported. We describe a case of gonococcal OIM abscess in an adolescent female whose condition was successfully diagnosed and managed with the use of CT-guided needle aspiration and antibiotic therapy. We review the English-language literature regarding the use of newly developed tools in the diagnosis of OIM abscess.
Assuntos
Abscesso/diagnóstico , Gonorreia/diagnóstico , Miosite/diagnóstico , Adolescente , Feminino , HumanosRESUMO
Congenital neuroectodermal defects are associated with meningitis that is unresponsive to conventional antibiotic therapy, recurrent bacterial meningitis, or meningitis due to an organism that is not usually the cause of this disease. Midthoracic dermoid and epidermoid cysts occur rarely and are easily overlooked. We report the case of a 13-month-old boy with meningitis that was unresponsive to antimicrobial therapy. We subsequently identified an intraspinal abscess, an infection due to Staphylococcus epidermidis, and a midthoracic dermoid cyst. We emphasize the need for clinicians to have a high index of suspicion and to make a careful physical examination when antibiotic treatment fails in patients with meningitis. We also provide a detailed anatomy of a midthoracic dermoid cyst and illustrate the usefulness of magnetic resonance imaging in preoperative diagnosis of congenital neuroectodermal defects.
