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静脉注射吸毒者发生播散性肌脓肿导致多发性神经病和霍纳综合征。

Multifocal neuropathy and Horner's syndrome due to disseminated pyomyositis in an intravenous drug user.

机构信息

Department of Medicine, Launceston General Hospital, 274-280 Charles Street, Launceston, TAS, 7250, Australia.

Faculty of Medicine, Launceston Clinical School, University of Tasmania, Launceston, TAS, 7250, Australia.

出版信息

Neurol Sci. 2023 Dec;44(12):4519-4524. doi: 10.1007/s10072-023-07024-z. Epub 2023 Aug 31.

Abstract

BACKGROUND

The formation of abscesses with necrosis within large, striated muscles leads to pyomyositis, a condition relatively rarely encountered outside the tropics. Intravenous drug users and other immunocompromised individuals are predisposed toward this infection, which may occur due to local or haematogenous spread of infection to skeletal muscles previously damaged by trauma, exercise, or rhabdomyolysis.

METHODS

We report a young male intravenous drug user with rhabdomyolysis due to use of a synthetic opioid, in whom disseminated pyomyositis was detected following evaluation for sciatic and radial neuropathies and Horner's syndrome and review available reports of peripheral nerve dysfunction in the setting of this uncommon infection. We searched online databases to identify all published reports on adult patients with pyomyositis complicated by peripheral nerve dysfunction.

CONCLUSIONS

Peripheral nerve dysfunction may rarely occur via local spread of infection or compression from abscesses.

摘要

背景

大而有条纹的肌肉内的脓肿伴坏死可导致化脓性肌炎,这种疾病在热带地区以外相对少见。静脉药物使用者和其他免疫功能低下者易患这种感染,可能由于感染通过局部或血源性传播至先前因创伤、运动或横纹肌溶解导致的骨骼肌而发生。

方法

我们报告了一名年轻男性静脉药物使用者,因使用合成阿片类药物导致横纹肌溶解症,在评估坐骨神经和桡神经病变以及霍纳氏综合征后发现播散性化脓性肌炎,并回顾了在这种罕见感染情况下外周神经功能障碍的可用报告。我们在线数据库中搜索了所有关于化脓性肌炎并发外周神经功能障碍的成年患者的已发表报告。

结论

外周神经功能障碍可能很少通过感染的局部扩散或脓肿的压迫发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/212c/10641057/2f4126e7fd4e/10072_2023_7024_Fig1_HTML.jpg

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