患有肌炎的住院儿童和青少年的临床特征和治疗方法

IF 2.9 4区 医学 Q3 IMMUNOLOGY
Pediatric Infectious Disease Journal Pub Date : 2024-09-01 Epub Date: 2024-05-16 DOI:10.1097/INF.0000000000004382
Sebastian Weber, Chloé Schlaeppi, Florence Barbey, Michael Buettcher, Beate Deubzer, Andrea Duppenthaler, Manon Jaboyedoff, Christian Kahlert, Lisa Kottanattu, Christa Relly, Noemie Wagner, Petra Zimmermann, Ulrich Heininger
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引用次数: 0

摘要

背景:肌炎是一种细菌性肌肉感染,是儿童和青少年肌肉骨骼疼痛的重要鉴别诊断之一。与热带地区相比,温带国家很少发现这种疾病,但发病率却在不断上升,而且缺乏重要的研究:这项回顾性多中心研究纳入了患者:结果:在331名患者中,102人符合病例定义。患者发病时的年龄从 2 周到 17 岁不等(中位数为 8 岁)。大多数患者无基础疾病,均表现为发热和局部疼痛。在脓毒性肌炎的相应部位,100 名患者(98%)活动受限,39 名患者(38%)出现局部肿胀。骨盆肌肉(57%)和腿部肌肉(28%)主要受到影响。94名(92%)和59名(57%)患者分别进行了血液或组织培养。其中,55 例(58%)血液和 52 例(88%)组织培养呈阳性,主要是金黄色葡萄球菌(分别为 35 例和 19 例)和化脓性链球菌(分别为 12 例和 15 例)。所有患者在住院期间都接受了抗生素治疗,中位数为 10 天(四分位数间距:7-17),随后 95 名患者(93%)又接受了门诊治疗,中位数为 16 天(四分位数间距:11-22)。59例(57%)患者需要手术治疗:结论:化脓性肌炎的诊断具有挑战性,需要高度警惕。血液和/或组织培养显示,金黄色葡萄球菌和化脓性葡萄球菌是主要致病菌。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical Characteristics and Management of Children and Adolescents Hospitalized With Pyomyositis.

Background: Pyomyositis, a bacterial muscle infection, is an important differential diagnosis in children and adolescents with musculoskeletal pain. In contrast to tropical regions, it is rarely recognized in temperate countries, but incidence is increasing and major studies are missing.

Methods: This retrospective multicenter study included patients <18 years of age hospitalized with pyomyositis in 11 Swiss children's hospitals between January 2010 and December 2022. Cases were identified by ICD-10 code (Myositis; M60-M60.9), and data was extracted from electronic hospital records.

Results: Of 331 patients identified, 102 fulfilled the case definition. Patient age at presentation ranged from 2 weeks to 17 years (median 8 years). The majority had no underlying illness and all presented with fever and localized pain. At the respective site of pyomyositis, 100 (98%) had impaired movement and 39 (38%) presented with local swelling. Pelvic (57%) and leg (28%) muscles were mostly affected. Blood or tissue cultures were obtained in 94 (92%) and 59 (57%) patients, respectively. Of those, 55 (58%) blood and 52 (88%) tissue cultures were positive, mainly for Staphylococcus aureus (35 and 19, respectively) and Streptococcus pyogene s (12 and 15, respectively). All patients received antibiotic treatment during hospitalization for a median of 10 days (interquartile range: 7-17), followed by outpatient treatment for a further median of 16 days (interquartile range: 11-22) in 95 (93%) patients. Fifty-nine (57%) patients required surgery.

Conclusions: Pyomyositis is a challenging diagnosis that requires a high level of awareness. Blood and/or tissue cultures revealed S. aureus and S. pyogenes as the predominant causative agents.

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来源期刊
CiteScore
6.30
自引率
2.80%
发文量
566
审稿时长
2-4 weeks
期刊介绍: ​​The Pediatric Infectious Disease Journal® (PIDJ) is a complete, up-to-the-minute resource on infectious diseases in children. Through a mix of original studies, informative review articles, and unique case reports, PIDJ delivers the latest insights on combating disease in children — from state-of-the-art diagnostic techniques to the most effective drug therapies and other treatment protocols. It is a resource that can improve patient care and stimulate your personal research.
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