RESUMO
A 5-year-old girl sought treatment for pyrexia of unknown origin. Despite prompt surgical drainage of a streptococcal septic arthritis of the ankle joint, her condition deteriorated. Multifocal pyomyositis was subsequently diagnosed. This was complicated by acute compartment syndrome in three extremities. With aggressive surgical and medical management, the child made a complete recovery. Orthopaedic clinicians in nontropical areas must familiarize themselves with this rare, potentially life-threatening, but eminently curable disease.
Assuntos
Síndrome do Compartimento Anterior/microbiologia , Artrite Infecciosa/complicações , Polimiosite/complicações , Infecções Estreptocócicas/complicações , Streptococcus pyogenes , Doença Aguda , Síndrome do Compartimento Anterior/diagnóstico , Síndrome do Compartimento Anterior/terapia , Antibacterianos/uso terapêutico , Artrite Infecciosa/diagnóstico , Artrite Infecciosa/cirurgia , Pré-Escolar , Terapia Combinada , Desbridamento , Diagnóstico Diferencial , Drenagem , Feminino , Febre/microbiologia , Humanos , Leucocitose/microbiologia , Imageamento por Ressonância Magnética , Dor/microbiologia , Polimiosite/diagnóstico , Infecções Estreptocócicas/diagnóstico , SupuraçãoRESUMO
Five oncology patients developed bacterial pyomyositis involving the anterior tibial compartment and resulting in compartment syndrome with ischemia and abnormalities of neuromuscular function. All patients were neutropenic and thrombocytopenic, and four were receiving or had recently received cancer chemotherapy. Three infections were due to gram-negative bacilli and two to Staphylococcus aureus. Appropriate antimicrobial therapy and surgical drainage in four patients resulted in the resolution of these infections with good residual muscle function. To our knowledge, primary pyomyositis has never previously been known to cause compartment syndrome.
