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免疫功能正常成年人的脓性肌炎:横纹肌溶解症的罕见并发症

[Pyomyositis in an immunocompetent adult: unusual complication of rhabdomyolysis].

作者信息

Poujois A, Mazevet D, Perrigot M

机构信息

Service de médecine physique et de réadaptation, hôpital de la Salpêtrière, 47, boulevard de l'Hôpital, 75675 cedex 13, Paris, France

出版信息

Ann Readapt Med Phys. 2003 Jun;46(5):251-4. doi: 10.1016/s0168-6054(03)00087-4.

Abstract

INTRODUCTION

Non-tropical pyomyositis is a commonly reported infection in immunodeficient patients' muscle but is rare without immunodeficiency.

CASE DESCRIPTION

We report the case of a 40-year-old woman admitted in the physical medicine and rehabilitation department for a motor and sensory loss of the lower limb; this disorder appeared after rhabdomyolysis due to prolonged lying position (suicide attempt). The initial diagnosis of sciatic nerve compression was not consistent with motor loss of adductor muscles. Clinical examination revealed soft tissue swelling in the proximal part of her lower limb. CT scan displayed pyomyositis of the thigh (hip adductors and gluteus medius), which was successfully treated by surgical incision and drainage in combination with antibiotherapy.

CONCLUSION

Non-tropical pyomyositis is rarely described without immunodeficiency but this diagnosis should be borne in mind when previous muscle trauma is associated to leukocytosis. Computed tomography and MRI are the tests of choice to confirm the diagnosis of pyomyositis and to differentiate it from other entities.

摘要

引言

非热带性脓性肌炎是免疫缺陷患者肌肉中常见的一种感染,但在无免疫缺陷的情况下较为罕见。

病例描述

我们报告了一名40岁女性的病例,她因下肢运动和感觉丧失入住物理医学与康复科;这种疾病在因长时间躺卧(自杀未遂)导致横纹肌溶解后出现。最初诊断为坐骨神经受压,但与内收肌的运动丧失不符。临床检查发现其下肢近端软组织肿胀。CT扫描显示大腿(髋内收肌和臀中肌)脓性肌炎,通过手术切开引流联合抗生素治疗成功治愈。

结论

非热带性脓性肌炎在无免疫缺陷的情况下很少被描述,但当既往肌肉创伤与白细胞增多相关时,应考虑这一诊断。计算机断层扫描和磁共振成像(MRI)是确诊脓性肌炎并将其与其他疾病相鉴别的首选检查。

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