Dunkerley G R, Older J, Onwochei B, Pazienza J
St. Clare's Hospital, Schenectady, New York, USA.
Am Fam Physician. 1996 Aug;54(2):565-9.
In the past, most cases of pyomyositis occurred among persons living in tropical climates, with the most common pathogen being Staphylococcus aureus. Increased numbers of cases have been reported more recently in North America, particularly in immunocompromised persons, such as those infected with the human immunodeficiency virus (HIV) and those with diabetes mellitus. These patients present with a wider variety of pathogens, including gram-negative bacteria, Streptococcus groups B, C and G, and Mycobacterium avium. Therefore, it seems prudent to consider pyomyositis in the differential diagnosis of persons with HIV infection, diabetes mellitus or other immunocompromising conditions, who present with persistent or worsening muscle aches and pains. Antibiotic treatment with a pencillinase-resistant penicillin is recommended for up to six weeks.
过去，多数脓性肌炎病例发生在热带气候地区的人群中，最常见的病原体是金黄色葡萄球菌。最近在北美报告的病例数有所增加，特别是在免疫功能低下的人群中，如感染人类免疫缺陷病毒（HIV）者和糖尿病患者。这些患者感染的病原体种类更多，包括革兰氏阴性菌、B、C和G组链球菌以及鸟分枝杆菌。因此，对于出现持续或加重的肌肉疼痛的HIV感染者、糖尿病患者或其他免疫功能低下的患者，在鉴别诊断中考虑脓性肌炎似乎是谨慎的做法。建议使用耐青霉素酶的青霉素进行抗生素治疗，疗程长达六周。
