Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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A Case of Pyomyositis and Toxic Shock Syndrome Caused by Methicillin Resistant Staphylococcus aureus

독성 쇼크 증후군을 동반한 Methicillin 저항성 황색 포도알균 화농성 근염 1례

  • Kim, Yang Kyong (Department of Pediatrics, College of Medicine, Inha University) ;
  • Kim, Dal Hyon (Department of Pediatrics, College of Medicine, Inha University) ;
  • Kim, Soon Ki (Department of Pediatrics, College of Medicine, Inha University) ;
  • Son, Byong Kwan (Department of Pediatrics, College of Medicine, Inha University) ;
  • Hong, Young Jin (Department of Pediatrics, College of Medicine, Inha University)
  • 김양경 (인하대학교 의과대학 소아과학교실) ;
  • 김달현 (인하대학교 의과대학 소아과학교실) ;
  • 김순기 (인하대학교 의과대학 소아과학교실) ;
  • 손병관 (인하대학교 의과대학 소아과학교실) ;
  • 홍영진 (인하대학교 의과대학 소아과학교실)
  • Received : 2004.08.12
  • Accepted : 2004.09.20
  • Published : 2005.01.15
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Abstract

Pyomysitis is a primary acute bacterial infection of large skeletal muscule, usually occuring in the absence of specific cause of infection. Pyomyositis has been reported mainly in tropical countries and was rare in temperate climates. but it has been recognized with increasing frequency. Toxic shock syndrome(TSS) is an acute mutisystemic disease characterized by high fever, hypotension, multisystem dysfunction and erythematous rash followed by skin desquamation 8-12 days after onset. Especially, TSS and pyomyositis are rare conditions in the pediatric population. We experienced one case in a healthy 13-year-girl who developed pyomyositis of the right ileac and gluteal muscles associated with TSS caused by methicillin resistant Staphylococcus aureus. We reports a case of acute pyomyositis with TSS, in which the diagnosis was difficult because of the relative rare incidence in temperate climates and its vague symptoms. To our knowledge, this is the first reported case of pyomyositis with TSS in Korean pediatric population.

저자들은 평소 건강하던 비 월경 시기의 13세 여아에서, 특별한 선행 요인 없이 발생한 화농성 근염과 이에 동반된 TSS 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

Keywords

References

  1. Ko SH, Park SO, Choi YW, Kim DK, Jung KS, Leu JS, et al. 1 case of pyomyositis. Infect Chemother 1999;22:261-6
  2. Han SH, Yoon JW, Chung HJ, Kim WJ, Kim MJ, Park SC et al. Klebsiella pyomyositis in a diabetic man. Infect Chemother 1995;3:295-9
  3. Todd J, Fishaut M, Kapral F, Welch T. Toxic shock syndrome associated phage-group I staphylococci. Lancet 1978; 2:1116-8
  4. Wiesenthal AM, Todd JK. Toxic shock syndrome in children aged 10 years or less. Pediatrics 1984;74:112-7
  5. Gahrn-Hansen B, Lundkvist L, Nielsen E. Pyomyositis and probable toxic shock syndrome caused by a toxin-1 producing strain of Satphylococcus aurues. Eur J Clin Microbiol Infect Dis 1989;8:89-90 https://doi.org/10.1007/BF01964129
  6. Immerman RP, Greenman RL. Toxic shock syndrome associated with pyomyositis caused by a strain of Staphylococcus aureus that doses not produce toxic shock syndrome toxin-1. J Infect Dis 1987;156:505-7 https://doi.org/10.1093/infdis/156.3.505
  7. Wolfe MW, Bennett JT. Pyomyositis with toxic shock syn- drome presenting as back pain and fever. Am J Orthop 1997;26:135-7
  8. Bartlett P, Reingold AL, Graham DR, Dan BB, Selinger DS, Tank GW, et al. Toxic shock syndrome associated with surgical wound infections JAMA 1982;247:1448-50 https://doi.org/10.1001/jama.247.10.1448
  9. Reingold AL, Hargrett NT, Dan BB, Shands KN, Strickland BY, Broome CV. Nonmenstrual toxic shock syndrome : a review of 130 cases. Ann Intern Med 1982;96:871 https://doi.org/10.7326/0003-4819-96-6-871
  10. Chesney PJ, Davis JP. Toxic shock syndrome. In : Feigin RD, Cherry JD, editors. Text book of pediatric infectious disease 5th ed. Philadelphia : WB Saunders Co, 2004:836-59
  11. Hackett SP, Stevens DL. Superantigens associated with staphylococcal and streptococcal toxic shock syndrome are potent inducers of tumor necrosis factor-beta synthesis. J Infect Dis 1993;168:232-5 https://doi.org/10.1093/infdis/168.1.232
  12. Schlievert PM. Role of superantigens in human disease. J Infect Dis 1993;167:997-1002 https://doi.org/10.1093/infdis/167.5.997
  13. McKenna UG, Meadows JA III, Brewer NS, Wilson WR, Perrault J. Toxic shock syndrome, a newly recognized disease entity : report of 11 cases. Mayo Clin Proc 1980;55: 663-72
  14. Davis JP, Chesney PJ, Wand PJ, LaVenture M. Toxic shock syndrome : epidemiologic features, recurrence, risk factors, and prevention. N Engl J Med 1980;303:1429-35 https://doi.org/10.1056/NEJM198012183032501
  15. Todd JK. Toxic shock syndrome In: Long SS, Pickering LK, Prober CG, editors. Principles and practice of pediatric infectious disease 2nd ed. Philadelphia : Churchill Livingstone Co, 2003:99-102
  16. Rich RR. Intravenous IgG : supertherapy for superantigens. J Clin Intravest 1993;91:378 https://doi.org/10.1172/JCI116209
  17. Scriba J. Beitrag zur aeiologe der myositis acuta. Dtsch A Chir 1885;22:197-202
  18. Gibson RK, Rosenthal SJ, Lukert BP. Pyomyosistis increasing recognition in temperate climates. Am J Med 1984;77:768-72 https://doi.org/10.1016/0002-9343(84)90383-8
  19. Chiedozi LC. Pyomyositis, review of 205 cases in 112 patients. Am J Surg 1979;137:255-9 https://doi.org/10.1016/0002-9610(79)90158-2
  20. Gubbay AJ, Isaacs D. Pyomyositis in children. Pediatr Infect Dis J 2000;19:1009-13 https://doi.org/10.1097/00006454-200010000-00015
  21. Nizet V. Myositis and pyomyositis. In : Long SS, Pickering LK, Prober CG, editors. Principles and practice of pediatric infectious disease 2nd ed. Philadelphia : Churchill Livingstone Co, 2003:458-62
  22. Jayoussi R, Bialik V, Eyal A, Shehadeh N, Etzioni A. Pyomyositis caused by vigorous exercise in a boy. Acta Paediatr 1995;84:226-7 https://doi.org/10.1111/j.1651-2227.1995.tb13618.x
  23. Grose C. Pyomyositis and Bacterial myositis. In : Feigin RD, Cherry JD, editors. Text book of pediatric infectious disease 5th ed. Philadelphia : WB Saunders Co, 2004:737-41