Frm. Jesus et I. Mendiolasegura, CLINICAL STAGE, AGE AND TREATMENT IN TROPICAL PYOMYOSITIS - A RETROSPECTIVE STUDY INCLUDING 40 CASES, Archives of medical research, 27(2), 1996, pp. 165-170
A comparative and retrospective trial of 40 patients with tropical pyo
myositis covering studies done between January 1, 1987 and November 31
, 1990, at the General Hospital at Cosamaloapan, Veracruz, IMSS, was u
ndertaken. The objectives were to compare predisposing factors, clinic
al data, morbidity, mortaity and hospital stay among 1) medical (group
I) and surgical treatment (II), 2) adult and pediatric populations an
d 3) the clinical stage of the disease (invasive, suppurative and late
). In group I, the family history of diabetes (56%), fever (66%) and h
ospital stay (6.5 +/- 1.8 days) were significantly different from grou
p II (19%, 100% and 12.8 +/- 5.5 days), respectively. The mean age in
adult and pediatric populations was 38 and 8 years, respectively. Pedi
atric patients had lowest hemoglobin levels (9.7 +/- 1.3). Upper respi
ratory antecedent was highest in suppurative stage (65%). In the late
stage eosinophilia (5.9 +/- 6.9), fluctuance muscles (100%), complicat
ion rate of 57%, surgical drainage (100%) and mortality of 29% were fo
und. Cultures were performed in 20 cases with negative results in 55%
and the remaining 45% were positive to Staphylococcus aureus. Pyomyosi
tis appears to be multifactorial in origin, the antecedents of trauma
and upper respiratory infection were the major predisposing factors. S
epticemia caused high morbidity and mortality in the late stage. Surgi
cal treatment was frequently needed, increasing costs.