Ghazala Christopher George, Fatone Elena, Bentley Ruth, Rajeev Aysha
Department of Trauma and Orthopaedic Surgery, Queen Elizabeth Hospital, Gateshead, Tyne and Wear, United Kingdom.
Department of Radiology, Queen Elizabeth Hospital, Gateshead, Tyne and Wear, United Kingdom.
J Emerg Med. 2016 Sep;51(3):319-21. doi: 10.1016/j.jemermed.2016.05.022. Epub 2016 Jun 28.
In nations with temperate climates, primary polymyositis is a rare, life-threatening bacterial infection that can mimic various clinical diseases depending on the area involved, leading to delayed diagnosis and management.
We describe a young postpartum woman who presented to the emergency department with hip pain that was initially suspected to be caused by septic arthritis. However, hip arthrocentesis was negative, and a magnetic resonance imaging scan revealed extensive pyomyositis of the gluteal muscles. She underwent surgical debridement and was given parenteral antibiotics with good clinical recovery. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: We emphasize that cases of pyomyositis in temperate countries are often diagnosed late and therefore delay life- and potentially limb-saving treatment. For patients who present with hip and thigh pain and clinical features of sepsis, pyomyositis should be considered in the differential diagnosis and an early magnetic resonance imaging scan should be performed to confirm the diagnosis and reduce the high morbidity and mortality associated with this emerging disease.
在气候温和的国家，原发性脓性肌炎是一种罕见的、危及生命的细菌感染，根据受累部位不同可表现出各种临床疾病，导致诊断和治疗延误。
我们描述了一名年轻的产后女性，她因髋部疼痛就诊于急诊科，最初怀疑是脓毒性关节炎所致。然而，髋关节穿刺术结果为阴性，磁共振成像扫描显示臀肌广泛脓性肌炎。她接受了手术清创，并接受了胃肠外抗生素治疗，临床恢复良好。急诊医生为何应知晓此事？：我们强调，在温带国家，脓性肌炎病例往往诊断较晚，因此延误了挽救生命和可能挽救肢体的治疗。对于出现髋部和大腿疼痛以及脓毒症临床特征的患者，在鉴别诊断中应考虑脓性肌炎，并应尽早进行磁共振成像扫描以确诊，降低与这种新出现疾病相关的高发病率和死亡率。
