Learning objectives
The purpose of our educational exhibit is to:
1. Illustrate the epidemiology,
etiology and complications of the neck pyomyositis
2.
Describe how to differentiate pyomyositis from other inflammatory processes in the neck
3.
Explain how the diagnosis is made by images of neck pyomyositis
Background
The pyomyositis is a primary pyogenic myositis of striated muscle.
The staphylococcus is the main etiological agent,
however recently there have been reports of unusual bacteria,
such as pneumonie streptococcus.
It is common to find such infection in lower trunk and limbs,
but it is unusual to see it in the neck muscles.
Cervical condition described in 0.5 to 4% of cases,
frequently associated with dental problems,
tonsil infection or trauma.
There are 2 types,
tropical and non-tropical.
Is endemic in tropical countries,
but there...
Findings and procedure details
The different methods of diagnostic imaging provide several keys for the diagnosis of pyomyositis.
Noninvasive radiologic methods,
such as ultrasound,
CT,
or MR imaging,
are useful in confirming the diagnosis but is not especifics.
Plain radiographs are not sensitive,
may suggest muscle enlargement,
loss of muscle definition,
obliteration of deep fat planes,
gas in soft tissues,
and reactive changes in adjacent bone.
X rayis more useful excluding differential diagnosis like osteomyelitis or musculoskeletal tumors.
Ultrasound is the initial screening tool,
shows hypoechoic areas with increased...
Conclusion
The pyomyositis is a rare entity even in its most common endemic form,
usually does not involve the neck.
This infection is more common in immunocompromised individuals,
then our cases are very atypicals because the patients are not immunocompromised.
Pyomyositis should be considered a differential in any painful swelling in the neck.
Complications of a non-timely diagnosis can be fatal; so a high index of suspicion is needed and know how to make a timely radiologic diagnosis,
improving patient outcome.
Radiologic imaging can help to...
References
Andrés Fernando Rodríguez-Gutiérrez,
Abraham Giraldo.
Piomiositis del músculo esternocleidomastoideo.
Reporte de un caso en Colombia y revisión de la literatura,Rev.
Fac.
Med.
(2014) 62(3) :465-469.
Rocio Gonzales Marquez,
Marta Morato.
Sternocleiomastoid,
Pyomyositis in an immunocompetent.
Acta otorrinolaringologica Esp.
(2014) 65(3): 202-204.
Raimundo Lopez Rodriguez,
Juaquin Campos franco.
Sternocleido and pectoralis mayor Pyomyositis in a inunocompetent patient.
Orthopedics.
(2008) 31(11): 238 – 240.
Vikas Agarwal,
Sandeep Chauhan,
Rakesh K.
Gupta.
Pyomyositis.
Neuroimag Clin N Am 21 (2011) 975–983.
Haris Marath,
Max Yates.Pyomyositis.
Journal of Diabetes and...