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Coombs S, Bui A, Mirzan HS, Robelin K, Garner HW, Krishna M, Cowart JB. Pyomyositis presenting as myonecrosis secondary to methicillin-resistant Staphylococcus aureus bacteremia in chronic lymphocytic leukemia. Proc AMIA Symp 2022; 35:665-667. [DOI: 10.1080/08998280.2022.2078647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Shannon Coombs
- Mayo Clinic Alix School of Medicine, Jacksonville, Florida
- Division of Hospital Internal Medicine, Mayo Clinic, Jacksonville, Florida
| | - Albert Bui
- Division of Hospital Internal Medicine, Mayo Clinic, Jacksonville, Florida
| | - Haares S. Mirzan
- Division of Hospital Internal Medicine, Mayo Clinic, Jacksonville, Florida
| | - Kimberly Robelin
- Division of Hospital Internal Medicine, Mayo Clinic, Jacksonville, Florida
| | | | - Murli Krishna
- Department of Pathology, Mayo Clinic, Jacksonville, Florida
| | - Jennifer B. Cowart
- Division of Hospital Internal Medicine, Mayo Clinic, Jacksonville, Florida
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Nakayama Y, Sugiyama A, Yamamoto T, Hyakudomi R, Hirahara N, Tajima Y. Pyomyositis in a Patient Undergoing Chemotherapy for Gastric Cancer: A Case Report and Literature Review. Case Rep Oncol 2021; 14:1220-1227. [PMID: 34703439 PMCID: PMC8460931 DOI: 10.1159/000518242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/26/2021] [Indexed: 12/02/2022] Open
Abstract
Pyomyositis has recently been recognized as a primary infection of the large skeletal muscles, and it is often accompanied by single or multiple intramuscular abscess formation. Immunocompromised patients, including those with diabetes mellitus, human immunodeficiency virus infection, and cancer, as well as those undergoing chemotherapy, are at a greater risk of developing pyomyositis. A 78-year-old Japanese man with recurrent gastric cancer being treated with chemotherapy presented with sudden-onset pain in his left lower extremity while undergoing a second-line regimen with irinotecan. T2-weighted magnetic resonance imaging (MRI) showed an abnormally high-intensity signal in the left internal and external obturator muscles, a finding consistent with pyomyositis. Following intensive antibiotic treatment, the patient recovered completely and was able to resume chemotherapy with irinotecan. For a patient who developed pyomyositis during chemotherapy for gastric cancer, early diagnosis using MRI followed by administration of timely intensive antibiotic therapy resulted in complete recovery.
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Affiliation(s)
- Yoko Nakayama
- Department of Surgery, Izumo City General Medical Center, Izumo, Japan
| | - Akira Sugiyama
- Department of Surgery, Izumo City General Medical Center, Izumo, Japan
| | - Tetsu Yamamoto
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Japan
| | - Ryoji Hyakudomi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Japan
| | - Noriyuki Hirahara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Japan
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Japan
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Wongsaengsak S, Quirch M, Ball S, Sultan A, Jahan N, Elmassry M, Rehman S. Docetaxel-induced acute myositis: a case report with review of literature. J Chemother 2020; 33:116-121. [PMID: 32619151 DOI: 10.1080/1120009x.2020.1785740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Docetaxel is an anti-microtubule agent and a highly effective treatment of locally advanced and metastatic breast cancer. There are several adverse effects associated with docetaxel, such as myelosuppression, peripheral neuropathy, fluid retention, and asthenia. One of the most well-known side-effects of this medication is mild to moderate myalgia. Here, we report a case of a 49-year-old female with stage 3 breast cancers who developed severe acute myositis following docetaxel use. The mechanism of docetaxel-induced myositis remains unclear; however, physicians still need to be aware of the possibility of this complication in patients with cancer and a history of exposure to this medication.
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Affiliation(s)
- Sariya Wongsaengsak
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Miguel Quirch
- Division of Hematology and Medical Oncology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Somedeb Ball
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Anita Sultan
- Division of Hematology and Medical Oncology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Nusrat Jahan
- Division of Hematology and Medical Oncology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Mohamed Elmassry
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Shabnam Rehman
- Division of Hematology and Medical Oncology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
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Habeych ME, Trinh T, Crum-Cianflone NF. Purulent infectious myositis (formerly tropical pyomyositis). J Neurol Sci 2020; 413:116767. [PMID: 32172014 DOI: 10.1016/j.jns.2020.116767] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 02/28/2020] [Accepted: 03/02/2020] [Indexed: 11/25/2022]
Abstract
Purulent infectious myositis (PIM), formerly known as tropical pyomyositis, is a pyogenic infection of skeletal muscles. Staphylococcus aureus, a normal human skin inhabitant, is the main pathogen involved, but multiple other microorganisms have been implicated. Although usually a progressive febrile disease with pain in the affected muscle(s), severe, life-threatening forms have been described, especially in immunosuppressed patients and children. PIM may elude early diagnosis given the lack of overlying skin changes. Hence, high index of suspicion followed by imaging modalities (ultrasonography when superficial and computed tomography or magnetic resonance imaging with contrast when deep) help confirm the diagnosis. Treatment requires combination of percutaneous or open surgical drainage along with antimicrobial therapy guided by culture results. The rising incidence of cases due to methicillin-resistant Staphylococcus aureus (MRSA) strains, makes the inclusion of vancomycin be recommended. This paper reviews PIM highlighting its global distribution, causative agents, predisposing factors, management, and potential complications.
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Affiliation(s)
- Miguel E Habeych
- Prince of Wales Clinical School, University of New South Wales (UNSW), Sydney, Australia.
| | - Terry Trinh
- Department of Neurology, Institute of Neurological Sciences, Prince of Wales Hospital, Sydney, Australia
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Sharma V, Subi TS, Chaudhary D, Patel M. A Case of Alveolar Rhabdomyosarcoma with Multifocal Pyomyositis Following Chemotherapy. Indian J Med Paediatr Oncol 2018. [DOI: 10.4103/ijmpo.ijmpo_138_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AbstractPyomyositis is extremely rare after chemotherapy for nonhematological malignancies. We report a patient of alveolar rhabdomyosarcoma, who developed multifocal pyomyositis in bilateral lower limbs after the first cycle of neoadjuvant chemotherapy with vincristine, ifosfamide, mesna, and etoposide. The diagnosis of pyomyositis was reached after ultrasound and contrast-enhanced computed tomography scan of bilateral lower limbs. Staphylococcus and Streptococcus were isolated from pus. This patient was treated with 4 weeks of antibiotics, besides ultrasound-guided pus aspiration and open surgical debridement. To the best of our knowledge, no case of rhabdomyosarcoma with pyomyositis following chemotherapy has been reported so far.
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Affiliation(s)
- Vibhor Sharma
- Department of Medical Oncology, Homi Bhabha Cancer Hospital, Sangrur, Punjab, India
| | - TS Subi
- Department of Surgical Oncology, Homi Bhabha Cancer Hospital, Sangrur, Punjab, India
| | - Debashish Chaudhary
- Department of Surgical Oncology, Homi Bhabha Cancer Hospital, Sangrur, Punjab, India
| | - Mehul Patel
- Department of Radiodiagnosis, Homi Bhabha Cancer Hospital, Sangrur, Punjab, India
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A Case of Docetaxel Induced Myositis and Review of the Literature. Case Rep Rheumatol 2015; 2015:795242. [PMID: 26257973 PMCID: PMC4519533 DOI: 10.1155/2015/795242] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 06/12/2015] [Accepted: 06/22/2015] [Indexed: 12/13/2022] Open
Abstract
In phase I and II trials taxane chemotherapeutic agents reported side effects, including myelosuppression, peripheral edema, and fluid retention. With further use of these agents, studies in the late 1980s and early 1990s began to report peripheral neuropathy and proximal muscle weakness as common complaints, the later with unexplained pathophysiology. We report a 65-year-old Hispanic woman with estrogen receptor (ER) and progesterone receptor (PR) positive invasive ductal breast carcinoma who presented with right thigh pain and swelling eight days after her third infusion of docetaxel (a taxane chemotherapeutic) and cyclophosphamide. Laboratory findings were notable for elevation in creatine phosphokinase (CPK), aldolase, and erythrocyte sedimentation rate (ESR); a magnetic resonance imaging (MRI) of her lower extremities showed evidence of bilateral muscle edema involving the anterior compartment muscles of the thighs. A workup to rule out other causes of myositis was negative. Docetaxel was not reintroduced and the patient improved with corticosteroids. Since 2005 this is, to our knowledge, the fifth reported case of docetaxel related inflammatory myositis. Taxanes have been noted to cause disabling but transient arthralgias and myalgias; it is important to consider the possibility of inflammatory myopathy as a possible complication in patients undergoing treatment with these agents.
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Nakao Y, Yokoyama M, Nishiyama S, Hashiguchi M, Aihara S, Yasunaga M, Noguchi M, Iwasaka T. Pyomyositis associated with chemotherapy for endometrial cancer: a case report. World J Surg Oncol 2013; 11:45. [PMID: 23442230 PMCID: PMC3598439 DOI: 10.1186/1477-7819-11-45] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Accepted: 11/26/2012] [Indexed: 11/16/2022] Open
Abstract
Pyomyositis is a rare complication of chemotherapy for non-hematological malignancies. A 58-year-old woman with endometrial carcinoma, in whom pyomyositis developed during adjuvant chemotherapy, was presented in this report. After initiating empiric antibiotic therapy for febrile neutrocytopenia, screening CT showed multiple abscesses in the lower limbs. Operative drainage of the abscess was effective.
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Affiliation(s)
- Yoshifumi Nakao
- Department of Obstetrics and Gynecology, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga, Saga 8498501, Japan.
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