Knees Michelle, Ayub Muhammad Talha, Manikkan Ajaydas
Medical Student, Chicago College of Osteopathic Medicine.
Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA.
Cureus. 2018 Apr 9;10(4):e2453. doi: 10.7759/cureus.2453.
Pyomyositis is an acute or sub-acute primary infection of the striated muscles. It is commonly misdiagnosed in its early stages due to its nonspecific presentation and lower suspicion among physicians when it comes to diagnosis. It has been historically associated with tropical climates but is being seen with increasing incidence in temperate regions. In both tropical and temperate areas, Staphylococcus aureus is the most common causative organism; gram-negative organisms are rare and traditionally only seen in immunocompromised patients. We report a case of Klebsiella pneumoniae pyomyositis in an immunocompetent patient with no risk factors. The awareness of the possibility of gram-negative pyomyositis in immunocompetent patients will broaden initial empiric antibiotic treatment, especially in those patients not responding to traditional empiric treatment.
脓性肌炎是一种横纹肌的急性或亚急性原发性感染。由于其非特异性表现以及医生在诊断时对其怀疑度较低,它在早期常被误诊。从历史上看,它与热带气候有关,但在温带地区的发病率也在不断上升。在热带和温带地区,金黄色葡萄球菌都是最常见的致病微生物;革兰氏阴性菌很少见,传统上仅见于免疫功能低下的患者。我们报告一例无危险因素的免疫功能正常患者发生肺炎克雷伯菌脓性肌炎的病例。认识到免疫功能正常的患者发生革兰氏阴性菌脓性肌炎的可能性,将拓宽初始经验性抗生素治疗的范围,尤其是对于那些对传统经验性治疗无反应的患者。