Pyomyositis is an acute infection of the skeletal muscles. In most cases, it is caused by the bacterium Staphylococcus aureus.
What is pyomyositis?
In medicine, pyomyositis is also known as pyomyositis tropicans, lambo lambo, bungpagga or myositis purulenta. What is meant by this is an acute infection of the skeletal muscles. This causes pain and tenderness in the affected muscle . In addition, pus-filled abscesses can form within the muscles.
Pyomyositis occurs primarily in tropical regions where it is endemic. Eastern Uganda is particularly affected. Between 400 and 900 cases of illness occur there every year. Most sufferers are men. About 13 percent of all patients die from pyomyositis. In principle, the infectious disease can occur at any age, but it is most common between the ages of 10 and 40. See sportingology for Meaning of DCIS in English.
In contrast, pyomyositis occurs only rarely in non-tropical areas. It is mainly adults and seniors who get sick there. In most cases, pyomyositis is a sequela of serious illnesses such as cancer associated with chemotherapy or AIDS. However, patients who have had an organ transplant and who need to take immunosuppressive drugs are also at risk.
About 20 percent of all pyomyositis patients have an HIV infection. About 25 percent of all those affected undertook a trip to tropical regions before the outbreak of the disease. 25 to 40 percent of all patients previously suffered an injury in the diseased muscle area as a result of an accident or the effects of violence.
Causes
Pyomyositis is caused by bacterial infection of the skeletal muscles. In most cases, the bacterium Staphylococcus aureus is responsible for the disease. The germ shows up in 90 to 95 percent of all patients in tropical countries and in 70 to 75 percent of all affected people in non-tropical countries.
The remaining pathogens are Streptococcus pyogenes, Streptococcus pneumoniae, Staphylococcus epidermis, Escherichia coli, Yersinia enterocolitica, Proteus mirabilis and various salmonella. Injuries are considered to be a common risk factor for pyomyositis infection. In addition to trauma, this also includes generalized muscle contractions that occur in the context of electrical accidents, as well as heavy loads.
Chronic diseases such as diabetes mellitus and the use of steroids and drugs such as zidovudine, which damage the muscles, are also classified as risk factors. Tropical pyomyositis can also be caused by viruses or helminthiasis caused by nematodes. The origin of pyomyositis has not yet been clarified exactly.
However, many facts speak for a bacterial genesis. Doctors suspect that the disease is a complication of bacteremia. Bacteria get into the blood. A muscle injury creates a spot with reduced resistance to bacterial attack, allowing bacteria to advance further. The release of iron from the myoglobin of damaged muscles is also said to promote the growth of the germs.
Symptoms, Ailments & Signs
Pyomyositis often results in abscesses, which can occur in any muscle in the body. Large muscles appear to be more likely to develop abscesses than smaller ones. Doctors refer to the first phase of pyomyositis as the invasive phase. It occurs about two weeks after infection. The symptoms that appear are considered non-specific and subacute.
They often go undetected. Loss of appetite and fever are typical symptoms. In addition, slight pain and swelling may occur. Some patients also suffer from overheating of the diseased areas and reddened skin. The second phase is called the festering phase.
It is characterized by chills, high fever and SIRS (Systemic Inflammatory Response Syndrome). There is also increased pain and tension in the muscles, skin inflammation and pus formation.
The third and most serious phase is the late phase, during which more pus forms. This leads to increased formation of abscesses and joint inflammation. In addition, the kidneys can fail and blood poisoning (sepsis), which is accompanied by septic shock, can occur.
Diagnosis & course of disease
The diagnosis of pyomyositis is considered difficult. Imaging methods and an ultrasound examination are used. With sonography, accumulations of pus in the muscles and disorders of the muscle structure can be detected. In the early stages of the disease, however, this is of limited use.
Magnetic resonance imaging (MRI) is used to determine the extent and location of the infection. The diagnosis can be confirmed by microbiological detection of the pathogen, with the abscess being punctured. If pyomyositis is detected in the first or second phase and treated accordingly, it usually takes a positive course. However, if the disease progresses, it can become life-threatening.
Complications
As a rule, the pyomyositis itself is diagnosed relatively late, since the symptoms are not particularly characteristic and ambiguous. Those affected suffer primarily from fever and a severe loss of appetite. This leads to a strong loss of weight and further deficiency symptoms.
These have a very negative effect on the quality of life and general health of those affected. The skin of those affected is reddened by the pyomyositis and there is swelling and pain. Patients also suffer from chills and joint pain. The muscles themselves are tense and cramps can occur. If the pyomyositis is not treated, the patient’s kidneys will also be damaged.
The kidneys no longer detoxify the body and blood poisoning occurs, from which the person concerned can ultimately die. The patients are then dependent on a kidney transplant or on dialysis due to the pyomyositis. Treatment of pyomyositis is carried out with the help of drugs. As a rule, the course of the disease is positive and there are no further complications. The patient’s life expectancy is also not affected if the treatment is successful.
When should you go to the doctor?
Pyomyositis should always be treated by a doctor. It is a serious and, above all, serious illness that cannot be treated by self-help. Further complications can only be avoided by medical treatment. A doctor should be consulted for pyomyositis if the affected person suffers from a high fever and severe loss of appetite.
Swelling can occur in various regions of the body, with the skin also appearing red and inflamed. If these symptoms persist and do not go away on their own, a doctor must be consulted. The internal organs can also be damaged. The affected person is often very warm and the muscles ache.
Pyomyositis can be diagnosed by a general practitioner. In emergencies, however, you can go to the hospital or call an ambulance. If pyomyositis is detected early, it can be treated relatively well.
Treatment & Therapy
To treat pyomyositis, the doctor usually performs surgical abscess drainage. Only rarely do the affected muscle areas have to be amputated. The patient is also given antibiotics. Their selection depends on the type of bacterium, possible resistance and Gram status. In the first phase of the disease, antibiotic treatment alone is often sufficient. The duration of therapy is usually from three to four weeks, but this depends on the extent of the pyomyositis.
Prevention
Promising measures to prevent pyomyositis are not known. In some cases, eliminating the staphylococci on the nasal mucosa by oral administration of rifampicin or topical treatment with mupirocin is considered useful.
Aftercare
As a rule, the measures or the options for aftercare in the case of pyomyositis are significantly limited or are not available to the person affected. The affected person is primarily dependent on a quick and, above all, early diagnosis of this disease, so that there are no complications or further spread of the tumor in the further course. Self-healing is usually not possible with this disease.
Those affected are usually dependent on taking various medications. You should always pay attention to the specified dosage and regular intake in order to relieve the symptoms properly and permanently. Regular check-ups by a doctor are also very useful and can prevent further damage.
Most of those affected also depend on the support of their own family or partner, which can prevent the development of depression or other psychological upsets. Pyomyositis does not reduce the life expectancy of the person affected. However, the further course of pyomyositis depends heavily on the time of diagnosis and the severity of the disease, so that a general prediction is not possible.