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Abbati G, Abu Rumeileh S, Perrone A, Galli L, Resti M, Trapani S. Pelvic Pyomyositis in Childhood: Clinical and Radiological Findings in a Tertiary Pediatric Center. CHILDREN 2022; 9:children9050685. [PMID: 35626862 PMCID: PMC9139856 DOI: 10.3390/children9050685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/04/2022] [Accepted: 05/06/2022] [Indexed: 11/16/2022]
Abstract
Pyomyositis (PM) is an infrequent but increasing bacterial infection of the skeletal muscle, with muscles of the pelvis and thigh frequently involved. The diagnosis is often challenging, especially when a deep muscle is affected. We present a single-center pediatric cohort affected by pelvic PM. A retrospective analysis was performed, including children admitted to Meyer Children’s Hospital between 2010 and 2020. Demographic, anamnestic, clinical, laboratory, radiological and management data were collected. Forty-seven patients (range 8 days–16.5 years, 66% males) were selected. Pain (64%), functional limitations (40%) and fever (38%) were the most common presenting symptoms; 11% developed sepsis. The median time to reach the diagnosis was 5 days (IQR 3–9). Staphylococcus aureus was the most common organism (30%), Methicillin-Resistant S aureus (MRSA) in 14%. PM was associated with osteomyelitis (17%), arthritis (19%) or both (45%). The infection was multifocal in 87% of children and determined abscesses in 44% (40% multiple). Pelvic MRI scan, including diffusion-weighted imaging (DWI), always showed abnormalities when performed. Clinical and laboratory findings in pelvic PM are unspecific, especially in infancy. Nevertheless, the infection may be severe, and the suspicion should be higher. MRI is the most useful radiological technique, and DWI sequence could reveal insidious infections.
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Affiliation(s)
- Giulia Abbati
- Paediatric Residency, Meyer Children’s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy;
- Department of Health Sciences, University of Florence, Viale Pieraccini 24, 50139 Florence, Italy; (L.G.); (S.T.)
- Correspondence: ; Tel.: +39-3389919979
| | - Sarah Abu Rumeileh
- Paediatric Residency, Meyer Children’s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy;
- Department of Health Sciences, University of Florence, Viale Pieraccini 24, 50139 Florence, Italy; (L.G.); (S.T.)
| | - Anna Perrone
- Radiology Unit, Meyer Children’s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy;
| | - Luisa Galli
- Department of Health Sciences, University of Florence, Viale Pieraccini 24, 50139 Florence, Italy; (L.G.); (S.T.)
- Infectious Disease Unit, Meyer Children’s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy
| | - Massimo Resti
- Paediatric Unit, Meyer Children’s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy;
| | - Sandra Trapani
- Department of Health Sciences, University of Florence, Viale Pieraccini 24, 50139 Florence, Italy; (L.G.); (S.T.)
- Paediatric Unit, Meyer Children’s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy;
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Characteristics of Neisseria Species Colonized in the Human’s Nasopharynx. Jundishapur J Microbiol 2020. [DOI: 10.5812/jjm.99915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Context: Neisseria meningitidis is the causative agent of a life-threatening infection with high mortality and morbidity worldwide. The most common types of this bacterium are serogroups A, B, C, W135, X, and Y. Although in some countries, such as Iran, the meningococcal meningitis has been well monitored and controlled by the use of divalent and quadrivalent vaccines, other fatal infections caused by these bacteria are still an important threat. For the above reason, this review focused on the differences of Neisseria characteristics, particularly in capsular composition, pathogenic and commensal stages to a better understanding of how to manage Neisseria infections. Evidence Acquisition: In this review, PubMed, EMBASE, ScienceDirect, Scopus, and Google Scholar were searched for English-language publications on pathogenic or commensal strains of Neisseria, meningococcal disease, Neisseria biology, genetic diversity, molecular typing, serogroups, diagnostic, and epidemiology around the world up to July 2019. All articles and academic reports in the defined area of this research were considered too. The data were extracted and descriptively discussed. Results: We included 85 studies in the survey. The data analysis revealed that the distribution of meningococcal serogroups was different regionally. For example, the serogroups C and W-135 accounted for Africa and Latin America regions, serogroup B in the European countries, and rarely in the Western Pacific, and serogroups A and C were dominant in Asian countries. Although data set for laboratory-based diagnosis of N. meningitidis are available for all countries, only 30% of the countries rely on reference laboratories for serogroup determination, and more than half of the countries lack the ability of surveillance system. Nevertheless, molecular detection procedure is also available for all countries. The use of the meningococcal vaccine is a variable country by country, but most countries have applied the meningococcal vaccine, either divalent or quadrivalent, for the protection of high-risk groups. Conclusions: Owing to the geographical distribution of N. meningitidis serogroups in circulating, each country has to monitor for changes in serogroups diversity and its control management. Furthermore, laboratories should scale up the epidemiology and disease burden. It should be mentioned that quadrivalent meningococcal vaccines reduce the meningococcal disease burden sharply.
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Martellosio JP, Lauda-Maillen M, Landron C, Le Moal G, Allouchery M, Arrivé F, Roblot P, Martin M. [Inflammatory myopathy following acute meningoccemia in a properdin-deficient patient: A case report]. Rev Med Interne 2019; 41:46-49. [PMID: 31735371 DOI: 10.1016/j.revmed.2019.10.339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 10/18/2019] [Accepted: 10/23/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Myalgia is a classical sign in invasive meningococcal diseases (IMD), but severe and persistent myalgia following an IMD have never been reported to date. CASE REPORT A 20-year-old man presented with purpura fulminans and meningitis caused by Neisseria meningitidis serogroup Y, revealing properdin deficiency. Although meningitis symptoms improved after antibiotherapy, initial myalgia of the lower limbs increased, associated with mild rhabdomyolysis. Magnetic resonance imaging (MRI) revealed an increased STIR (Short TI inversion recovery) signal of both quadriceps muscles, without abscess. After exclusion of other causes of myopathy, a post-infectious myositis was diagnosed. A four-week course of corticosteroids led to dramatic improvement. CONCLUSION Post-infectious inflammatory myopathy should be suspected in case of severe and persistent myalgia associated with rhabdomyolysis following an IMD, after exclusion of pyomyositis especially. A short course of corticosteroids seems to be effective.
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Affiliation(s)
- J-P Martellosio
- Service de médecine interne, maladies infectieuses et tropicales, CHU de Poitiers, 2 rue de la Milétrie, 86021 Poitiers cedex, France.
| | - M Lauda-Maillen
- Service de médecine interne, maladies infectieuses et tropicales, CHU de Poitiers, 2 rue de la Milétrie, 86021 Poitiers cedex, France
| | - C Landron
- Service de médecine interne, maladies infectieuses et tropicales, CHU de Poitiers, 2 rue de la Milétrie, 86021 Poitiers cedex, France
| | - G Le Moal
- Service de médecine interne, maladies infectieuses et tropicales, CHU de Poitiers, 2 rue de la Milétrie, 86021 Poitiers cedex, France
| | - M Allouchery
- Service de pharmacologie clinique et vigilances, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers cedex, France
| | - F Arrivé
- Service de médecine interne, maladies infectieuses et tropicales, CHU de Poitiers, 2 rue de la Milétrie, 86021 Poitiers cedex, France
| | - P Roblot
- Service de médecine interne, maladies infectieuses et tropicales, CHU de Poitiers, 2 rue de la Milétrie, 86021 Poitiers cedex, France
| | - M Martin
- Service de médecine interne, maladies infectieuses et tropicales, CHU de Poitiers, 2 rue de la Milétrie, 86021 Poitiers cedex, France
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Moris V, Chapuis A, Guillier D, Jeudy G, Huther M, Auffret N, Piroth L, Blot M. Necrotizing fasciitis caused by genogroup × Neisseria meningitidis. QJM 2017; 110:589-590. [PMID: 28911029 DOI: 10.1093/qjmed/hcx109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Indexed: 11/12/2022] Open
Affiliation(s)
- V Moris
- Service de Chirurgie Maxillo-Faciale
| | | | | | | | | | | | - L Piroth
- Service de Maladies Infectieuses et Tropicales, CHU François Mitterand, Dijon, France
| | - M Blot
- Service de Maladies Infectieuses et Tropicales, CHU François Mitterand, Dijon, France
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Haemophilus influenzae Pyomyositis in a Patient with Diabetic Ketoacidosis: A Unique Case and Review of Literature. Case Rep Infect Dis 2017; 2017:6307361. [PMID: 28352482 PMCID: PMC5352866 DOI: 10.1155/2017/6307361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 02/06/2017] [Indexed: 11/17/2022] Open
Abstract
Haemophilus influenzae is a Gram-negative bacillus commonly known to cause upper respiratory tract infections. Skin and soft tissue infections are very uncommon. Of these, the majority were associated with necrotizing fasciitis requiring emergent debridement. We report a case of pyomyositis caused by Haemophilus influenzae in an adult with diabetes.
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