Sharma Umesh, Schwan William R, Agger William A
Hospital Medicine, Mayo Clinic Health System, 700 West Ave S, La Crosse, WI 54601, USA.
WMJ. 2011 Aug;110(4):182-4.
Pyomyositis due to Escherichia coli (E. coil) is rarely reported in immunocompromised patients with hematological malignancy.
We present a case report of a 34-year-old man who developed E. coli pyomyositis as a complication of acute myelogenous leukemia (AML). Magnetic resonance imaging (MRI) of the right hip suggested myofascial infection of the gluteal muscles, and a needle muscle aspiration grew E. coli phylogenetic group B2. The patient responded to intravenous piperacillin/tazobactam followed by prolonged oral levofloxacin.
Pyomyositis should be suspected in all immunocompromised patients complaining of muscle pain and may exhibit signs of localized muscle infection. Appropriate antibiotic therapy targeting fluoroquinolone-resistant E. coli should be considered for initial empiric therapy of pyomyositis in immunocompromised patients.
在血液系统恶性肿瘤的免疫功能低下患者中，由大肠杆菌引起的脓性肌炎鲜有报道。
我们报告一例34岁男性患者，其发生大肠杆菌脓性肌炎，为急性髓系白血病（AML）的并发症。右髋部磁共振成像（MRI）提示臀肌肌筋膜感染，经针吸肌肉培养出大肠杆菌B2系统发育群。患者静脉注射哌拉西林/他唑巴坦后，再长期口服左氧氟沙星，病情好转。
对于所有主诉肌肉疼痛的免疫功能低下患者，均应怀疑脓性肌炎，其可能表现出局部肌肉感染的体征。对于免疫功能低下患者脓性肌炎的初始经验性治疗，应考虑使用针对耐氟喹诺酮大肠杆菌的适当抗生素治疗。
