Senior Resident, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh, India.
Associate Professor, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh, India.
Trop Doct. 2024 Apr;54(2):91-97. doi: 10.1177/00494755231219775. Epub 2023 Dec 11.
Recent data have demonstrated the changing epidemiology of primary pyomyositis worldwide. Our hospital-based retrospective study investigated the clinical and microbiological spectrum of primary pyomyositis between 2013 and 2021 in PGIMER (Chandigarh), India. Over a quarter had predisposing conditions, mainly diabetes mellitus and immunosuppressive therapy. Fever, muscle pain, local swelling and breathlessness were the usual presentations, with quadriceps, iliopsoas and gluteal muscles commonly affected. was the predominant cause, with c.50% methicillin-resistant strains. Almost two-thirds presented with metastatic infection (stage 3 pyomyositis), frequently with septic lung emboli. Patients with methicillin-sensitive and resistant had a similar incidence of metastatic infection. In-hospital mortality was c.10% and was strongly associated with a high international normalised ratio. Primary pyomyositis remains a significant problem, with a dramatic increase in community-associated methicillin-resistant .
最近的数据表明，原发性肌炎的全球流行病学正在发生变化。我们的医院回顾性研究调查了 2013 年至 2021 年印度昌迪加尔 PGIMER 原发性肌炎的临床和微生物学谱。超过四分之一的患者存在诱发因素，主要是糖尿病和免疫抑制治疗。发热、肌肉疼痛、局部肿胀和呼吸困难是常见的表现，股四头肌、髂腰肌和臀肌是常见的受累部位。金黄色葡萄球菌是主要的病原体，其中约 50%为耐甲氧西林菌株。近三分之二的患者出现转移性感染（3 期肌炎），常伴有脓毒性肺栓塞。耐甲氧西林敏感和耐药金黄色葡萄球菌的患者转移性感染的发生率相似。住院死亡率约为 10%，与国际标准化比值高密切相关。原发性肌炎仍然是一个严重的问题，社区相关性耐甲氧西林金黄色葡萄球菌的数量急剧增加。
