Iliopsoas Pyomyositis With Bacteremia at an Early Stage of Presentation in a Temperate Region.
Iliopsoas Pyomyositis With Bacteremia at an Early Stage of Presentation in a Temperate Region.
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DOI：
10.7759/cureus.26854
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发表时间：
2022-07
影响因子：
1.2
通讯作者：
Sano, Chiaki
中科院分区：
文献类型：
--
作者：
Amano, Shiho;Ohta, Ryuichi;Sano, Chiaki
腰大肌脓肿是一种在腰大肌内聚集脓液的疾病，这种疾病很少见，但随着计算机断层扫描（CT）和磁共振成像（MRI）的使用，其发病率正在增加。化脓性肌炎是一种不会导致脓肿形成的肌肉感染，被称为热带化脓性肌炎，因为它在热带地区非常流行。我们遇到一个髂腰肌化脓性肌炎和菌血症没有脓肿形成的情况下。血培养呈阳性，尽管早期的表现和没有脓肿形成的MRI。影像学检查是诊断髂腰肌损伤的金标准。有些病例与我们的病例相似，在脓肿形成之前血培养就呈阳性。无论MRI上是否发现脓肿，我们都需要在早期阶段考虑假阴性的可能性。在体检中对该病的怀疑至关重要，以便早期诊断和治疗，特别是在医疗资源有限的农村地区。此外，化脓性肌炎是热带地区的常见疾病，但近年来，在温带地区发生的病例报告有所增加。此病例提示即使在温带地区，也需要考虑将脓肌炎作为发热和髋关节疼痛的鉴别诊断。
A psoas abscess, a collection of pus in the psoas muscle, is rare but the incidence is increasing with the use of computed tomography (CT) and magnetic resonance imaging (MRI). Pyomyositis, a muscular infection that does not lead to abscess formation, is well known as tropical pyomyositis because it is highly prevalent in tropical areas. We encountered a case of iliopsoas pyomyositis and bacteremia without abscess formation. The blood culture was positive despite the early stage of presentation and no abscess formation on MRI. Imaging is the gold standard for diagnosing iliopsoas abscesses. There are cases similar to ours wherein the blood culture is positive before the formation of an abscess. Regardless of whether an abscess is found on MRI or not, we need to consider the possibility of false negatives at the early stage of presentation. A suspicion of this disease is essential during a physical examination for early diagnosis and treatment, especially in rural areas, where medical resources are limited. Furthermore, pyomyositis is a common disease in tropical regions, but in recent years, case reports of occurrences in temperate regions have increased. This case indicates the need to consider pyomyositis as a differential diagnosis of fever and hip joint pain even in temperate regions.