Information ⬇
- Clinical manifestations and microbiology: Infections involving the muscle have differing manifestations, depending on the etiology.
- - Myositis: can be caused by bacteria (clostridia, streptococci), viruses (influenza virus, dengue virus, coxsackievirus), or parasites (Trichinella, Taenia solium, Toxoplasma). This condition usually manifests with myalgias, but pain can be severe in coxsackievirus, Trichinella, and bacterial infections.
- - Pyomyositis: a localized muscle infection usually due to S. aureus, common in tropical areas, and typically with no known portal of entry
- - Myonecrosis: can be caused by clostridial species (C. perfringens, C. septicum, C. histolyticum, C. sordellii) or by mixed aerobic and anaerobic bacteria. Myonecrosis is usually related to trauma; however, spontaneous gangrene—usually due to C. septicum—can occur in pts with neutropenia, GI malignancy, or diverticulosis. Myonecrosis of the uterus, typically due to C. sordellii, occurs in women after spontaneous or medically induced abortion and in healthy postpartum women; infection is rapidly and almost uniformly fatal as there are few or no localizing clinical findings.
- Diagnosis and Treatment: Emergent surgical intervention to visualize deep structures, obtain materials for culture and sensitivity testing, remove necrotic tissue, and reduce compartment pressure is both diagnostic and therapeutic.
- - Empirical antibiotic treatment should target likely etiologies—e.g., vancomycin (1 g IV q12h) for pyomyositis and ampicillin/sulbactam (2-3 g IV q6h) for mixed aerobic-anaerobic infections.
- - For treatment of clostridial myonecrosis (gas gangrene), see Table 84-1.
Outline ⬆
Section 7. Infectious Diseases
- 78. Infections Acquired in Health Care Facilities
- 79. Infections in the Immunocompromised Host
- 80. Infective Endocarditis
- 81. Intraabdominal Infections
- 82. Infectious Diarrheas
- 83. Sexually Transmitted and Reproductive Tract Infections
- 84. Infections of the Skin, Soft Tissues, Joints, and Bones
- 85. Pneumococcal Infections
- 86. Staphylococcal Infections
- 87. Streptococcal/Enterococcal Infections, Diphtheria, and Infections Caused by Other Corynebacteria and Related Species
- 88. Meningococcal and Listerial Infections
- 89. Infections Caused by Haemophilus, Bordetella, Moraxella, and HACEK Group Organisms
- 90. Diseases Caused by Gram-Negative Enteric Bacteria and Pseudomonas
- 91. Infections Caused by Miscellaneous Gram-Negative Bacilli
- 92. Anaerobic Infections
- 93. Nocardiosis, Actinomycosis, and Whipple's Disease
- 94. Tuberculosis and Other Mycobacterial Infections
- 95. Lyme Disease and Other Nonsyphilitic Spirochetal Infections
- 96. Rickettsial Diseases
- 97. Mycoplasma Pneumoniae, Legionella Species, and Chlamydia Pneumoniae
- 98. Chlamydia Trachomatis and C. Psittaci
- 99. Herpesvirus Infections
- 100. Cytomegalovirus and Epstein-Barr Virus Infections
- 101. Influenza and Other Viral Respiratory Diseases
- 102. Rubeola, Rubella, Mumps, and Parvovirus Infections
- 103. Enteroviral Infections
- 104. Insect- and Animal-Borne Viral Infections
- 105. HIV Infection and AIDS
- 106. Fungal Infections
- 107. Pneumocystis Infections
- 108. Protozoal Infections
- 109. Helminthic Infections and Ectoparasite Infestations