Obturator externus abscess in a 9-year-old child: A case report and literature review.

Détails

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Etat: Public
Version: Final published version
ID Serval
serval:BIB_AB9268AEF03A
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Titre
Obturator externus abscess in a 9-year-old child: A case report and literature review.
Périodique
Medicine
Auteur(s)
de Bodman C., Ceroni D., Dufour J., Crisinel P.A., Bregou-Bourgeois A., Zambelli P.Y.
ISSN
1536-5964 (Electronic)
ISSN-L
0025-7974
Statut éditorial
Publié
Date de publication
04/2017
Peer-reviewed
Oui
Volume
96
Numéro
9
Pages
e6203
Langue
anglais
Notes
Publication types: Case Reports ; Journal Article
Publication Status: ppublish
Résumé
Obturator pyomyositis is a rare condition in children. Diagnosis is often delayed because of its rarity, and the vagaries of its presentation cause it to be easily be missed. Physicians should therefore familiarize themselves with this condition and consider it as a possible differential diagnosis in patients presenting with an acutely painful hip. Inflammatory syndrome is also frequent among sufferers and the MRI is a very sensitive diagnostic tool for obturator pyomyositis. Additionally, joint fluid aspirations and blood cultures are also useful in identifying the pathogen. The appropriate antibiotic therapy provides a rapid regression of symptoms during the early stage of pyomyositis. In cases of MRI-confirmed abscess, surgical treatment is indicated.
Our report focuses on a case of obturator pyomyositis in a 9-year-old boy. The child was febrile for 5 days and could only manage to walk a few steps. His hip range of motion was restricted in all directions. In addition, the patient had presented pain and swelling of his right elbow for a day, with a restriction of motion in the joint. There was a clear inflammatory syndrome. A diagnosis of hip and elbow septic arthritis was suspected, and the child underwent joint aspiration of the both cited joints. The aspiration of the elbow returned pus. Conversely, no effusion was found in the hip aspiration. The administration of empiric intravenous antibiotherapy was started.
An MRI revealed an osteomyelitis of the ischio-pubic area associated with a subperiosteal abscess.
Subsequently, 3 days after elbow arthrotomy, a surgical treatment was performed on the patient's right hip in order to evacuate the subperiosteal abscess and muscular collection because of the persistence of the patient's symptoms and inflammatory syndrome despite susceptible intravenous antibiotics. Postsurgery the patient showed steady improvement.
Such cases demonstrate how diagnosis can be difficult because pelvic pyomyositis is often mistaken for more common pathologies such as septic arthritis, osteomyelitis, or appendicitis. This may delay the diagnosis or refer misdiagnosis. We discuss this rare infection in light of the literature with particular reference to its incidence, clinical features, bacteriological etiology, biological, and radiological presentation, and above all, its treatment.

Mots-clé
Child, Humans, Male, Osteomyelitis/diagnosis, Osteomyelitis/therapy, Pyomyositis/diagnosis, Pyomyositis/therapy
Pubmed
Web of science
Open Access
Oui
Création de la notice
07/03/2017 18:40
Dernière modification de la notice
20/08/2019 15:15
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