Pyomyositis associated with abscess formation caused by streptococcus pneumoniae in children: a case report and review of literature

Italian Journal of Pediatrics

Case Report

Federico Bonvicini¹  Alessandro De Fanti¹  Michele Fastiggi¹  Luca Barchi²  Lorenzo Iughetti²  Ilaria Bassoli²  Monica Silvotti³ 

[1] Paediatrics Unit, Santa Maria Nuova Hospital, AUSL-IRCCS of Reggio Emilia, 42123, Reggio Emilia, Italy;School of Pediatric, University of Modena and Reggio Emilia, 41224, Modena, Italy;Unit of Radiology, IRCCS-Arcispedale Santa Maria Nuova, 42123, Reggio Emilia, Italy;

关键词: Children;    Pyomyositis;    Psoas abscess;    Myositis;    Streptococcus Pneumoniae;   

DOI  :  10.1186/s13052-023-01472-1

 received in 2023-04-06, accepted in 2023-05-11,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPyomyositis is an unusual bacterial infection but potential severe in children. Staphylococcus Aureus is the main caused of this disease (70–90%), following by Streptococcus Pyogenes (4–16%). Streptococcus Pneumoniae rarely caused invasive muscular infections. We describe a case of pyomyositis caused by Streptococcus Pneumonia in an adolescent 12-year-old female.Case presentationI.L. referred to our hospital for high fever associated with right hip and abdominal pain. The blood exams showed increase of leukocytes with prevalence of neutrophils with high level of inflammatory markers (CRP 46,17 mg/dl; Procalcitonin 25,8 ng/ml). The abdomen ultrasonography was unremarkable. The CT and MRI of the abdomen and right hip revealed pyomyositis of the iliopsoas, piriformis and internal shutter associated with collection of pus between the muscular planes (Fig. 1). The patient was admitted to our paediatric care unit, and she was initially treatment with intravenous Ceftriaxone (100 mg/kg/day) and Vancomycin (60 mg/kg/day). On day 2, a pansensitive Streptococcus Pneumoniae was isolated from the blood culture, and the antibiotic treatment was changed to only IV Ceftriaxone. She was successively treated with IV Ceftriaxone for 3 weeks, then continued with oral Amoxicillin for a total of 6 weeks of therapy. The follow up showed a complete resolution of the pyomyositis and psoas abscess after 2 months.ConclusionPyomyositis associate with abscess is a rare and very dangerous disease in children. The clinical presentation can mimic symptoms of other pathologies like osteomyelitis or septic arthritis, so many times is hard to identify. The main risk factors include story of recent trauma and immunodeficiency, not present in our case report. The therapy involves the antibiotics and, if possible, abscess drainage. In literature there is much discussion about duration of antibiotic therapy.

【 授权许可】

CC BY   
© The Author(s) 2023

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