Viani R M, Bromberg K, Bradley J S
Division of Pediatric Infectious Diseases, University of California at San Diego, USA.
Clin Infect Dis. 1999 Jan;28(1):117-22. doi: 10.1086/515080.
Obturator internus muscle (OIM) abscess is an uncommon entity often mistaken for septic arthritis of the hip. We describe seven children with OIM abscess and review seven previously reported cases. The most common presenting symptoms were hip or thigh pain (14 patients), fever (13), and limp (13). The hip was flexed, abducted, and externally rotated in 11 patients. Magnetic resonance imaging and computed tomography (CT) were diagnostic for OIM abscess in the 14 patients. Associated abscesses were located in the obturator externus muscle (5 patients), psoas muscle (2), and iliac muscle (1). The etiologic agents were Staphylococcus aureus (8 patients), Streptococcus pyogenes (2), Neisseria gonorrhoeae (2), and Enterococcus faecalis (1). Three patients underwent CT-guided percutaneous drainage, and three had surgical drainage. Three patients had ischial osteomyelitis in addition to OIM abscess. The 11 children with uncomplicated OIM abscess were treated for a median of 28 days. All patients had an uneventful recovery.
闭孔内肌脓肿是一种罕见的病症，常被误诊为髋关节化脓性关节炎。我们描述了7例闭孔内肌脓肿患儿，并回顾了7例先前报道的病例。最常见的症状是髋部或大腿疼痛（14例）、发热（13例）和跛行（13例）。11例患者髋关节呈屈曲、外展和外旋位。14例患者经磁共振成像和计算机断层扫描（CT）诊断为闭孔内肌脓肿。相关脓肿位于闭孔外肌（5例）、腰大肌（2例）和髂肌（1例）。病原体为金黄色葡萄球菌（8例）、化脓性链球菌（2例）、淋病奈瑟菌（2例）和粪肠球菌（1例）。3例患者接受了CT引导下经皮引流，3例接受了手术引流。3例患者除闭孔内肌脓肿外还患有坐骨骨髓炎。11例单纯闭孔内肌脓肿患儿的治疗时间中位数为28天。所有患者均顺利康复。
