Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2012; 79(2):156-161 | DOI: 10.55095/achot2012/024

Primární pyomyozitida svalů v oblasti kyčelního kloubu: kazuistiky a přehled literaturyKazuistika

K. KOUDELA Jr.^1,*, J. KOUDELOVÁ², T. SKALICKݳ

¹ Klinika ortopedie a traumatologie pohybového ústrojí FN a LFUK Plzeň

² Klinika zobrazovacích metod FN a LF UK Plzeň

³ Chirurgická klinika FN a LF UK Plzeň

The authors present three case reports of primary pyomyositis, a severe but rare disorder involving the muscles around the hip. In three boys, with an average age of 16 years, the disease developed suddenly in association with strenuous sporting activities. The boys had fever, pain and restricted motion at hip joints, haemoculture tests positive for Staphylococcus aureus and the presence of inflammatory markers. Magnetic resonance findings showed infiltrates and abscesses in the muscles around the hip. X-ray and computed tomography (CT) examination of the pelvis revealed bone irregularities near the pubic symphysis due to repeated avulsion injury to the medial group of the thigh muscles in two boys, and a fresh avulsion of the anterior inferior iliac spine in one boy. This patient developed reactive synovitis of the hip and iliopectineal bursitis. All three patients received intravenous antibiotic therapy, first with broad-spectrum and then with specific anti-staphylococcus antibiotics, for 2 to 3 months. Repeated puncture and drainage of the abscesses under CT guidance was performed in one patient; repeated surgery with abscess removal was necessary in two patients. The early diagnosis and combined conservative and surgical treatment prevented development of the third, septic stage of this disease which is commonly associated with serious complications.

Klíčová slova: primary pyomyositis, hip muscles, Staphylococcus aureus

Zveřejněno: 1. duben 2012  Zobrazit citaci