Obturator Pyomyositis in a Pediatric Patient Resolved by Ultrasound-Guided Percutaneous Drainage. Case Report
Abstract
The objective of this case report is to present the management of a case of pyogenic myositis of the obturator muscle in a pediatric patient using ultrasound-guided percutaneous drainage. The patient is a 5-year-old pediatric patient with clinical and laboratory manifestations of deep muscular infection at the obturator level, an area of difficult surgical access, for which the least invasive treatment possible was used to drain purulent content from the affected area. The use of magnetic resonance imaging studies allows for a more accurate diagnosis in cases of early pyogenic infection, as well as determining the most effective approach to treatment. In some cases, ultrasound guidance can be used to avoid a formal surgical approach, reducing wound complications and morbidity and mortality. The addition of image-guided percutaneous procedures is a very useful tool for the treatment of infectious diseases and a great help to the orthopedist.Downloads
References
Pannunzio ME, Praino ML, Carballo CM, Medranda AC, Orlando MN, Biondi EJ, et al. Piomiositis en niños: experiencia en un hospital pediátrico de referencia en Argentina. Rev Chil Infectol 2019;36(3):371-5.
https://doi.org/10.4067/S0716-10182019000300371
Planchet J, Urbina Y, Barreto O, Correa J. Piomiositis, artritis séptica y osteomielitis aguda por Staphylococcus aureus meticilino resistente de la comunidad en paciente pediátrico. Rev Digit Postgrado 2021;10(3):e321. https://doi.org/10.37910/ RDP.2021.10.3.e321
Altmayer S, Verma N, Dicks EA, Oliveira A. Imaging musculoskeletal soft tissue infections. Semin Ultrasound, CT MRI 2019;41(1):85-98. https://doi.org/10.1053/j.sult.2019.09.005
Kavukçu S, Koşay C, Çakmakçi H, Öztürk Y, Anal Ö. Primary pyomyositis mimicking transient synovitis of the hip in a child: A case report. Turkish J Rheumatol 2012;27(2):128-31. https://doi.org/10.5606/tjr.2012.019
Elzohairy MM. Primary pyomyositis in children. Orthop Traumatol Surg Res 2018;104(3):397-403.
https://doi.org/10.1016/j.otsr.2017.12.005
Valderrama-Beltrán S, Cortés JA, Caro MA, Cely-Andrade L, Osorio-Pinzón JV, Gualtero SM, et al. Guía de
práctica clínica para el diagnóstico y manejo de las infecciones de piel y tejidos blandos en Colombia. Infectio 2019;23(4):318-46. https://doi.org/10.22354/in.v23i4.805
Karakatsanis A, Lykoudis P, Nastos C, Chronopoulos E, Koutoulidis V, Polymeneas G, et al. Bilateral obturator pyomyositis with visceral involvement in an immunocompetent adult patient treated without surgery. Surg Infect (Larchmt) 2014;15(5):651-5. https://doi.org/10.1089/sur.2012.147
Henríquez-Camacho C. La ecografía clínica en el diagnóstico diferencial de las infecciones del aparato locomotor. Acta Reum 2018;4(1):1-2. https://doi.org/10.3823/1330
Yahalom G, Guranda L, Meltzer E. Internal obturator muscle abscess caused by Klebsiella pneumoniae. J Infect 2007;54:157-60. https://doi.org/10.1016/j.jinf.2006.09.011
King R, Laugharne D, Kerslake R, Holdsworth B. Primary obturator pyomyositis: A diagnostic challenge. J Bone Joint Surg Br 2003;85(6):895-8. PMID: 12931815
Bertrand SL, Lincoln ED, Prohaska MG. Primary pyomyositis of the pelvis in children: a retrospective review of 8 cases. Orthopedics 2011;34(12):e832-e840. https://doi.org/10.3928/01477447-20111021-07
Angelis S, Trellopoulos A, Kondylis AK, Mirtsios H, Katsimantas A, Solakis EP, et al. Multifocal osteomyelitis localization after pyomyositis in children: Importance of timely response. Cureus 2019;11(4):e4463. https://doi.org/10.7759/cureus.4463
Levitt DL, Byer R, Milleret AF. Point-of-care ultrasound to diagnose pyomyositis in a child. Pediatr Emerg Care 2019;35(1):69-71. https://doi.org/10.1097/PEC.0000000000001711
Sivitz AB, Lam SHF, Ramirez-Schrempp D, Valente JH, Nagdev AD. Effect of bedside ultrasound on management of pediatric soft-tissue infection. J Emerg Med 2010;39(5):637-43. https://doi.org/10.1016/j.jemermed.2009.05.013
Vij N, Ranade AS, Kang P, Belthur MV. Primary bacterial pyomyositis in children: A systematic review. J Pediatr Orthop 2021;41(9):e849-e854. https://doi.org/10.1097/BPO.0000000000001944
Manuscript acceptance by the Journal implies the simultaneous non-submission to any other journal or publishing house. The RAAOT is under the Licencia Creative Commnos Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional (CC-BY-NC.SA 4.0) (http://creativecommons.org/licences/by-nc-sa/4.0/deed.es). Articles can be shared, copied, distributed, modified, altered, transformed into a derivative work, executed and publicly communicated, provided a) the authors and the original publication (Journal, Publisher and URL) are mentioned, b) they are not used for commercial purposes, c) the same terms of the license are maintained.
In the event that the manuscript is approved for its next publication, the authors retain the copyright and will assign to the journal the rights of publication, edition, reproduction, distribution, exhibition and communication at a national and international level in the different databases. data, repositories and portals.
It is hereby stated that the mentioned manuscript has not been published and that it is not being printed in any other national or foreign journal.
The authors hereby accept the necessary modifications, suggested by the reviewers, in order to adapt the manuscript to the style and publication rules of this Journal.
