Resumo

BAHUTE, André et al. Piomiosite pélvica em idade pediátrica: uma série de casos clínicos. Rev. Port. Ortop. Traum. [online]. 2015, vol.23, n.4, pp.310-319. ISSN 1646-2122.

Objective: Pyomyositis is a rare infection of the striated muscle and which generally results from hematogenous spread of septic emboli and usually presents with muscular abscesses. Clinical presentation is uncharacteristic and late diagnosis is frequent. We present 5 cases of pelvic pyomyositis in pediatric patients and review the current knowledge on this entity. Methods: We review 5 patients with an average age of 11 years old who were diagnosed with and treated for pelvic pyomyositis between 2012 and 2014. The site of infection was the iliopsoas in 3 cases and the obturator internus and piriformis in one each. In all cases the diagnosis was confirmed through imaging studies and intravenous antibiotic therapy was pursued until improvement of inflammatory markers and, afterwards, replaced for oral compounds. Blood cultures were conducted before the administration of antibiotics, but only in one case were we able to identify the offending microbe (Staphylococcus aureus). Results: None of the clinical or laboratorial findings were specific for pyomyositis. In three cases, the diagnosis was confirmed with pelvic MRI. The remaining 2 cases were confirmed with pelvic ultrasound and pelvic CT respectively. All patients were treated with intravenous and oral antibiotics exclusively for a length of 5 to 6 weeks. Conclusions: Early diagnosis of pyomyositis is rare and difficult. The use of MRI allows a precise assessment of the location of the lesion in the muscle and its extent. Early antibiotic therapy is usually successful and long term complication rates are low.

Palavras-chave : Pyomyositis; muscle abscess; pelvic infection; children; Staphylococcus aureus.

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