Cases reported "Myositis"

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1/37. Staphylococcal pyomyositis in a patient with non-Hodgkin's lymphoma.

    pyomyositis is a rare disease, encountered mainly in tropical climates. The diagnosis of this entity is difficult, if not misdiagnosed, because of its rarity and its subacute presentation. We report of a 42-year-old man, in whom pyomyositis developed while he was receiving the standard chemotherapy for T-cell non-Hodgkin's lymphoma (NHL). Three months following splenectomy, multiple abscesses occurred in the muscles of both thighs while the patient was receiving the third course of the CHOP regimen. A purulent exudate was aspirated from the abscesses under computed tomographic guidance. coagulase-positive Staphylococcus aureus was cultured in the aspirate. pyomyositis was completely resolved following the surgical drainage and the antistaphylococcal antibiotic treatment. This patient has shown that immunosuppression due to splenectomy, NHL, and chemotherapy, especially when using steroids, could be risk factors for pyomyositis in nontropical or semitropical countries.
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2/37. pyomyositis of the iliacus muscle in a child.

    pyomyositis is rarely seen in temperate climates. Typically, it presents with the formation of an abscess requiring surgical drainage and it has been reported as a differential diagnosis for septic arthritis of the hip. We describe the occurrence of pyomyositis of the iliacus muscle in a ten-year-old girl which was diagnosed by MRI and blood culture. Formation of an abscess did not occur despite marked focal inflammation and swelling of the muscle. Conservative treatment with antibiotics alone led to complete clinical and radiological resolution of the infection. We could find no previous description of pyomyositis in a child in the British orthopaedic literature. Orthopaedic surgeons, particularly those with a paediatric interest, should be aware of this condition and its presentation, diagnosis and treatment.
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3/37. Myositis resulting from disseminated cryptococcosis in a patient with hepatitis c cirrhosis.

    We report a case of myositis that resulted from disseminated cryptococcosis in a patient with hepatitis c cirrhosis. One year after cessation of treatment, the patient remains symptom free with negative results of serum cryptococcal antigen tests and negative culture results.
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4/37. MRSA pyomyositis complicating sickle cell anaemia.

    A patient being treated for sickle cell crisis developed swollen, painful, indurated, discoloured thighs after several days in hospital. Imaging revealed the presence of multiple small abscesses in the muscle and methicillin resistant staphylococcus aureus (MRSA) was cultured from aspirated fluid. pyomyositis usually occurs in association with damaged muscle and impaired host defences. Staphylococcus is the most frequent organism involved. It is not a common complication of sickle cell disease, although it may be under diagnosed. Availability of advanced imaging techniques facilitates early diagnosis of pyomyositis.
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5/37. Fatal aspergillus fumigatus Myositis in an immunocompetent patient.

    A 69-year old farmer developed Aspergillus myositis in the right psoas and paravertebral muscles extending to the retroperitoneum and the fifth lumbar vertebra. The infection appeared after two local instillations of steroid for back pain. Although the patient was not immunocompromised, surgical drainage and antifungal therapy failed to cure him; he died of a bacterial pulmonary superinfection while cultures of the abscess drainage fluid grew Aspergillus. The likely portal of entry in this patient was direct inoculation during infiltration of the steroid; the steroid probably caused a local impairment in host defenses. Only six cases of Aspergillus myositis have been reported previously. All of them occurred in severely immunosuppressed patients and the outcome was fatal in all cases.
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6/37. Adductor myositis as a cause of childhood hip pain.

    Two cases of bacterial adductor myositis that presented as painful hips in boys aged 4 and 9 years are reported. Clinically, there was severe pain and a high pyrexia, a raised c-reactive protein and positive blood cultures but a negative hip ultrasound. Urgent magnetic resonance imaging demonstrated changes throughout the adductor muscles in keeping with bacterial myositis. Both boys settled with intravenous antibiotic therapy. We propose that magnetic resonance imaging is a valuable tool in the assessment of infection around the hip and should be indicated when other investigations have excluded a septic arthritis but the child remains unwell.
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7/37. A Sweet-like syndrome manifesting as gingival hyperplasia and myositis without cutaneous involvement.

    Sweet's syndrome or acute febrile neutrophilic dermatosis, characterized by fever, neutrophilia, and focal infiltration of the dermis was originally described after episodes of infection. It is also known to occur in acute myeloid leukemia. A patient with acute myeloid leukemia (AML M3) developed gingival hyperplasia and muscle swelling and tenderness after starting treatment with all- trans retinoic acid. Microscopic examination showed neutrophilic infiltrate. All cultures were sterile. The lesions did not respond to cytotoxic therapy and continued to persist even after achievement of remission. The response was seen only after prednisolone was started. This case highlights the fact that a Sweet-like syndrome can occur without the characteristic cutaneous lesions and in such situations there can be considerable diagnostic and therapeutic difficulty.
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8/37. cryptococcus neoformans myositis without dissemination.

    We report a case of isolated cryptococcal myositis involving the paraspinal muscle without evidence of disseminated disease in a patient with a large B-cell lymphoma diagnosed at the time of presentation. biopsy of the muscle involved grew a pure culture of cryptococcus neoformans and periodic acid-Schiff staining showed numerous budding yeast consistent with Cryptococcus spp. The patient responded to systemic antifungal therapy with complete resolution of his infection. We also present a review of 5 previously published cases of cryptococcal myositis.
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9/37. Necrotising fasciitis and myositis that originated from gastrointestinal bacterial infection: two fatal cases.

    We present two cases of aggressive myofasciitis after gastrointestinal infections. The first patient developed necrosis of the legs over 5 days and he died on the 20th day. vibrio vulnificus was cultured. The second patient developed bullae on his thigh and he died the next day. streptococcus pyogenes was cultured.
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10/37. Tuberculous pyomyositis in a renal transplant recipient.

    Infections are a major cause of morbidity and mortality in renal transplant recipients. Although these patients are susceptible to many types of infection, soft tissue infections are rare. We report a case of tuberculous pyomyositis involving the left erector spinae muscle but with no other manifestations of tuberculosis. The diagnosis was suspected from the CT scan appearance and confirmed by microscopy and culture of the pus. Surgical incision and drainage, together with antituberculosis therapy, cured the infection. The relevant literature is briefly reviewed.
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