Orlicek S L, Abramson J S, Woods C R, Givner L B
Department of Pediatrics (Infectious Diseases), Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
J Pediatr Orthop. 2001 Nov-Dec;21(6):744-8.
The authors describe four cases of obturator internus muscle (OIM) abscess in children, including their clinical presentations and treatment. This was a retrospective chart review. Children and adolescents younger than 18 years discharged between July 1, 1985, and September 30, 1998, from Brenner Children's Hospital with the diagnosis of muscle abscess or pelvic abscess were identified. A total of 56 patients were identified with the diagnosis of muscle abscess or pelvic abscess. OIM abscess was defined by radiologic findings of an inflammatory process with fluid collection in the OIM, along with the clinical findings suggestive of an OIM abscess. Four of the patients met the definition of OIM muscle abscess. The common presenting features were fever, limp, and hip pain. Computed tomography or magnetic resonance imaging was diagnostic in all four patients, and Staphylococcus aureus was the causative agent in each. All the patients recovered, one after surgical drainage and the other three after antimicrobial therapy alone or with needle aspiration. The presentation of OIM pyomyositis is similar to that of psoas muscle pyomyositis and other infectious processes of the pelvis and hip. The S. aureus is the most common etiologic agent but not the only one reported. Most patients can be managed without open surgical drainage, but needle aspirations may be helpful both therapeutically and diagnostically.
作者描述了4例儿童闭孔内肌（OIM）脓肿病例，包括其临床表现及治疗情况。这是一项回顾性病历审查。确定了1985年7月1日至1998年9月30日期间从布伦纳儿童医院出院、诊断为肌肉脓肿或盆腔脓肿的18岁以下儿童及青少年。共有56例患者被诊断为肌肉脓肿或盆腔脓肿。OIM脓肿的定义为闭孔内肌出现伴有液体积聚的炎症过程的影像学表现，以及提示OIM脓肿的临床症状。其中4例患者符合OIM肌肉脓肿的定义。常见的临床表现为发热、跛行和髋关节疼痛。计算机断层扫描或磁共振成像对所有4例患者均具有诊断价值，每例患者的病原体均为金黄色葡萄球菌。所有患者均康复，1例经手术引流后康复，另外3例仅通过抗菌治疗或联合针吸术康复。OIM脓性肌炎的表现与腰大肌脓性肌炎以及骨盆和髋关节的其他感染性疾病相似。金黄色葡萄球菌是最常见的病原体，但并非唯一报道的病原体。大多数患者无需进行开放性手术引流，但针吸术在治疗和诊断方面可能均有帮助。
