PYOMYOSITIS

Background
P yo myositis is an infla mmation of mus cle tissue, usuall y of voluntar y muscles
that results in pus production. Once considered a tropical disease, it is now
s e e n i n t e m p e r a t e climates as well.

The pathogenesis is unclear, but trauma, infections (S. aureus, S. pneumoniae),and malnutrition have
been implicated. Although most cases of pyomyositis occur in healthyindividuals, other
pathogenetic factors include nutritional deficiency and associated parasitic infection in
tropical climates. In the temperate climates, pyomyositis is seen most commonly in patients with diabetes,
HIV infection, and malignancy.

Clinical Presentations

Presentation with painful, tender, localized swelling over muscle
Fever

Epidural abscess
Complications

Life-threatening complications include sepsis and toxic shock syndrome.
Diagnosis

CT scan or MRI demonstrates muscle abscess.

Aspiration of abscess (by surgery or CT/US guided) yields pus, usually yielding
S. aureus
.

Bacteremia may accompany.
Treatment
Medical Care

Promptly administer systemic antibiotics. This could eliminate the need for surgical drainage
in selected cases.

T h e c h o i c e o f a n t i b i o t i c i s d e t e r m i n e d b y i d e n t i f i c a t i o n o f t h e c a u s a t i v e organism.

Antibiotics initially are given intravenously until clinical improvement is noted, followed by
oral antibiotics for a total course of 3 weeks (eg, cefazolinor ceftriaxone IV followed by cephalexin PO).
Surgical Care

During the suppurative phase, abscess aspiration under ultrasonic or CT guidance may berequired.
Surgical drainage is especially necessary for large abscesses.

Complicated cases may require fasciotomies and debridement.
Prognosis

Prompt administration of antibiotics can result in complete resolution.

Specific Objectives: Define Pyomyositis. Shall have a comprehensive assessment and implement care base on our knowledge and skills of the condition. Shall have familiarized with effective interpersonal skills to emphasize health promotion andillness prevention. Trace the pathogenesis based on the signs and symptoms manifested by the patient. Use the nursing process as the framework for the care of the patient. . Determine appropriate medical and nursing management for the patient. Shall have imparted the learning experience from direct patient care. Identify the signs and symptoms manifested by the patient. Significance of the Study in Nursing Field: Shall have critical thinking skills necessary for providing safe and effective nursing care. Distinguish the precipitating and predisposing factors that trigger this development.

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Family Background Baby Dyein is the youngest among the four siblings. tuberculosis. But as the swelling and fever still persevered. patient together with her older brother had a fall as shewas given a piggy backride. diabetes. Past Health History Had cough.PATIENT’S PROFILE Name: Baby DyeinSex: FemaleBirthday: October 2007Age: 2 . Her mother had her massaged by a so-called manghihilot . except that the eldestchild does not go to school anymore as she decided to stop studying and just help work. Patient was given Paracetamol and wasreferred to Philippine Orthopedic Center. E. . Patient fell on her left scapular area and complained of pain. Immunization Record With complete record of immunization. Lifestyle and Diet She eats three times a day and drinks 5-6 glasses of water a day though mostly breastfeedon her mother. F. 2010Time of Admission: 8:40 PMAdmission Diagnosis: Pyomyositis Left Scapular AreaAttending Physician: Dr. D. diabetes.Economic Status She does not go to school yet. colds and fever but is only hospitalized once – now due to pyomyositis. Family Health History No family history of pyomyositis. Three weeks prior to consultation. G. B. Present Health History One month prior to consultation. patientstill complained of pain and endured of fever and localized swelling on the left scapular area. De Guzman A. The rest of the siblings are funded for their educationalexpenses by one of their mother’s rich customers as a laundry woman. C.3 y/oReligion: Roman CatholicCivil Status: Single Nationality: FilipinoDate of Admission: July 27. Another hilot session was done and patient was given TSB. patient was brought to the nearest clinic. Patient was admitted. hypertension. Educational and Socio . nor anyother diseases reported.