Die nicht-tropische Pyomyositis - ein seltenes Krankheitsbild in gemäßigten Klimazonen

Zusammenfassung

Bei einer Pyomyositis handelt es sich um eine in unserer Klimazone seltene akute bakterielle Infektion der Skelettmuskulatur ohne offensichtliche lokale oder benachbarte Infektionsquelle. Zu den initialen Symptomen zählen neben Muskelschmerzen auch lokale Schwellungen und Spannungen. Die Diagnose der Pyomyositis erfolgt in aller Regel verspätet, da oft zunächst andere Ursachen in Erwägung gezogen werden. Anhand dreier Fallbeispiele wird die Diagnostik und Therapie der Pyomyositis vor dem Hintergrund der derzeitig zu diesem Thema verfügbaren Literatur diskutiert.

Abstract

Pyomyositis is in the moderate climate zone a rare and acute bacterial infection of the skeletal muscles without an obvious origin of infection. Initial symptoms contain muscle pain and localized swelling and tension. As different causes are taken into account first, the diagnosis of a pyomyositis is often delayed. We report on three cases of pyomyositis and discuss diagnosis and therapy against the background of the available and recent literature.

Pyomyositis - bakterielle Infektion - Staphylokokkus aureus - Skelettmuskulatur - multiple Abszesse

pyomyositis - bacterial infection - staphylococcus aureus - skeletal muscles - multiple abscesses

Literatur

• 1 Adams E M, Gudmundsson S, Yocum D E, Haselby R C, Craig W A, Sundstrom W R. Streptococcal myositis.  Arch Intern Med. 1985;  145 1020-1023
• 2 Ameh E A. Pyomyositis in children: analysis of 31 cases.  Ann Trop Paediatr. 1999;  19 263-265
• 3 Andrew J G, Czyz W M. Pyomyositis presenting as septic arthritis. A report of 2 cases.  Acta Orthop Scand. 1988;  59 587-588
• 4 Blatt J, Reaman G, Pizzo P A. Pyomyositis in acute lymphocytic leukemia heralded by cutaneous vasculitis: brief communication.  Med Pediatr Oncol. 1979;  7 237-239
• 5 Caldwell D S, Kernodle G W, Seigler H F. Pectoralis pyomyositis: an unusual cause of chest wall pain in a patient with diabetes mellitus and rheumatoid arthritis.  J Rheumatol. 1986;  13 434-436
• 6 Chacha P B. Muscle abscesses in children.  Clin Orthop. 1970;  70 174-180
• 7 Chiedozi L C. Pyomyositis. Review of 205 cases in 112 patients.  Am J Surg. 1979;  137 255-259
• 8 Ellis M, Gupta S, Galant S, Hakim S, VandeVen C, Toy C, Cairo M S. Impaired neutrophil function in patients with AIDS or AIDS-related complex: a comprehensive evaluation.  J Infect Dis. 1988;  158 1268-1276
• 9 Ganesh R, Castle D, McGibbon D, Phillips I, Bradbeer C. Staphylococcal carriage and HIV infection.  Lancet. 1989;  2 558
• 10 Gaut P, Wong P K, Meyer R D. Pyomyositis in a patient with the acquired immunodeficiency syndrome.  Arch Intern Med. 1988;  148 1608-1610
• 11 Gibson R K, Rosenthal S J, Lukert B P. Pyomyositis. Increasing recognition in temperate climates.  Am J Med. 1984;  77 768-772
• 12 Gold H S, Moellering R C. Antimicrobial-drug resistance.  N Engl J Med. 1996;  335 1445-1453
• 13 Goldberg J S, London W L, Nagel D M. Tropical pyomyositis: a case report and review.  Pediatrics. 1979;  63 298-300
• 14 Hall R L, Callaghan J J, Moloney E, Martinez S, Harrelson J M. Pyomyositis in a temperate climate. Presentation, diagnosis, and treatment.  J Bone Joint Surg [Am]. 1990;  72 1240-1244
• 15 Horn C V, Master S. Pyomyositis tropicans in Uganda.  East Afr Med J. 1968;  45 463-471
• 16 Jackson D W, Feagin J A. Quadriceps contusions in young athletes. Relation of severity of injury to treatment and prognosis.  J Bone Joint Surg [Am]. 1973;  55 95-105
• 17 Kallen P, Nies K M, Louie J S, Keller M, Worthen N, Bayer A S. Tropical pyomyositis.  Arthritis Rheum. 1982;  25 107-110
• 18 Malhotra R, Singh K D, Bhan S, Dave P K. Primary pyogenic abscess of the psoas muscle.  J Bone Joint Surg [Am]. 1992;  74 278-284
• 19 Mitsuyasu R, Gale R P. Bacterial pyomyositis in a patient with aplastic anaemia.  Postgrad Med J. 1980;  56 61-62
• 20 Mueller P R, Ferrucci J T, Wittenberg J, Simeone J F, Butch R J. Iliopsoas abscess: treatment by CT-guided percutaneous catheter drainage.  AJR Am J Roentgenol. 1984;  142 359-362
• 21 Peckett W R, Butler-Manuel A, Apthorp L A. Pyomyositis of the iliacus muscle in a child.  J Bone Joint Surg [Br]. 2001;  83 103-105
• 22 Rodgers W B, Yodlowski M L, Mintzer C M. Pyomyositis in patients who have the human immunodeficiency virus. Case report and review of the literature.  J Bone Joint Surg [Am]. 1993;  75 588-592
• 23 Schwartzman W A, Lambertus M W, Kennedy C A, Goetz M B. Staphylococcal pyomyositis in patients infected by the human immunodeficiency virus.  Am J Med. 1991;  90 595-600
• 24 Smith I M, Vickers A B. Natural history of 338 treated and untreated patients with staphylococcal septicaemia (1936-1955).  Lancet. 1960;  1 1318-1322
• 25 Spiegel D A, Meyer J S, Dormans J P, Flynn J M, Drummond D S. Pyomyositis in children and adolescents: report of 12 cases and review of the literature.  J Pediatr Orthop. 1999;  19 143-150

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