CLINICAL STAGE, AGE AND TREATMENT IN TROPICAL PYOMYOSITIS - A RETROSPECTIVE STUDY INCLUDING 40 CASES

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.