Case Reports
Tropical Myositis (Pyomyositis) in Children in Temperate Climates: A Report of 3 Cases on Long Island, New York, and a Review of the Literature
Am J Orthop. 2007 May;36(5):E71-E75
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Jacob Weinberg, MD, Samara Friedman, MD, Sunil Sood, MD, and Russell J. Crider, MD
Dr. Weinberg is Assistant Professor, Division of Pediatric Orthopaedics and Scoliosis, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.
Dr. Friedman is Clinical Fellow, Orthopaedic Surgery, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania.
Dr. Sood is Chief, Pediatric Infectious Diseases, Schneider Children's Hospital at North Shore University Hospital, Manhasset, New York.
Dr. Crider is Attending Orthopaedic Surgeron, Division of Pediatric Orthopaedic Surgery, Schneider Children's Hospital, New Hyde Park, New York, and Associate Clinical Professor of Orthopaedic Surgery, New York University School of Medicine, New York, New York.
Abstract not available. Introduction provided instead.
Pyomyositis is a primary bacterial infection of skeletal muscle with initial clinical features of fever, localized muscle pain and stiffness, swelling, and tenderness.1 This infection is most commonly seen in tropical climates and thus is also called tropical myositis. Four percent of all patients admitted to hospitals in Uganda have this disease.2 Shepherd3 reported an incidence of 1 per 1000 population per year in Uganda and New Guinea. Tropical pyomyositis is usually caused by Staphylococcus aureus.4
Relatively few cases of this disease have been reported in temperate climates. According to a literature review, 100 cases of pyomyositis were reported in North America between 1971 and 1992.5 More recently, a few additional cases were found in the northeastern United States, at institutions in Boston,6 Rochester,7 Philadelphia,8 and New Jersey.9 Cases have also been reported in temperate European countries, such as Belgium10,11 and England.12-14 Whether pyomyositis in temperate zones is becoming more common or is simply recognized more often is not clear.
As early antibiotic treatment of infectious myositis is usually curative, it is important to entertain this diagnosis even in temperate climates. Delayed diagnosis and late institution of antibiotic treatment can lead to abscess formation, require surgical drainage, and yield poorer results.
In this article, we report 3 cases of pyomyositis in children treated at our institution in Long Island, New York, over a period of 6 months.