[Pediatric pyomyositis: Experience in a Pediatric Reference Center in Argentina]

Rev Chilena Infectol. 2019 Jun;36(3):371-375. doi: 10.4067/S0716-10182019000300371.
[Article in Spanish]

Abstract

Background: Pyomyositis is the infection of skeletal muscle, a rare pathology in children. Aim To describe the characteristics of pyomyositis in pediatric patients.

Methods: Prospective analytical study of hospitalized children diagnosed with pyomyositis from May 2016 to April 2017 at the Ricardo Gutiérrez Children's Hospital, Buenos Aires, Argentina.

Results: Twenty-one patients with pyomyositis were identified. Annual rate: 21.5/10,000 admissions (95% CI 4.65-71.43). The median age was 5.4 years (range 1.25-11.6). The lower limbs were the most affected site. C-reactive protein (CRP) was elevated in all patients, with a mean of 124 mg/L (SD 96), being significantly higher in patients with bacteremia: 206 (DS 101) vs 98 (DS 81), p = 0.02. Bacterial cultures were positive in 17/21 (80.9%): 15 methicillin-resistant Staphylococcus aureus (MRSA), and 2 Streptococcus pyogenes. Blood cultures were positive in 5 (23.8%).

Conclusion: MRSA-community acquired is the predominant pathogen in our setting. In the selection of the appropriate empirical treatment, the local resistance pattern and the CRP value should be taken into account.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Argentina
  • Bacteremia / diagnosis*
  • Bacteremia / drug therapy
  • Bacteremia / microbiology
  • C-Reactive Protein / analysis
  • Child
  • Child, Preschool
  • Clindamycin / therapeutic use
  • Drainage
  • Female
  • Hospitals, Pediatric
  • Humans
  • Infant
  • Lower Extremity
  • Male
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification
  • Prospective Studies
  • Pyomyositis / diagnosis*
  • Pyomyositis / drug therapy
  • Pyomyositis / microbiology
  • Staphylococcal Infections / diagnosis*
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / microbiology
  • Ultrasonography
  • Vancomycin / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Clindamycin
  • Vancomycin
  • C-Reactive Protein