| Autor: |
Otedo, AEO, Oyoo, GO, Otieno, JO, Otieno, CF, Omonge, EO |
| Jazyk: |
angličtina |
| Rok vydání: |
2014 |
| Zdroj: |
East African Medical Journal; Vol 90, No 12 (2013): Supplement; S48-S52 |
| ISSN: |
0012-835X |
| Popis: |
Background: Pyomyositis is a bacterial infection of the large skeletal muscles presenting with muscle pain and swelling. It is commonly seen in the tropics but is being recognised more in end-stage HIV/AIDS. In HIV-associated pyomyositis, leukocytosis and bacteraemia is rare due to deranged immune response. Surgical drainage, antibiotic treatment and HAART are the mainstay of treatment.Objective: To describe pyomyositis in HIV positive patients, their CD4+ cell counts, clinical stages of pyomyositis and anatomical sites affected.Design: Cross sectional, prospective, descriptive, consecutive entry study.Setting: Kisumu District Hospital and Nairobi Rheumatology Clinic between January 2002 to December 2007.Subjects: Twelve patients with HIV infection and pyomyositis.Main Outcome Measures: CD4+ cell counts, clinical stage and site of pyomyositis.Results: Twelve patients (six males and six females) were enrolled with mean age of 39.3 years (24-52). Pyomyositis was localised in the following regions:two each in gluteal and calf, six in the thigh and one each in the right arm and abdominal wall. CD4+ cell counts were low with a mean of 166.8 cells/µl (1.0-433) (normal range is 355-1600 cells/µl), indicating severe immunosuppression. They also had leucocytopaenia with a mean white blood cell count of 3.67 ~ 103/µl (1.5-7.1 ~ 103/µl) with a mean neutrophil count of 62.7% (43-78). Random blood sugar and creatine kinase levels were all normal. The co-morbidities comprised one case of deep venous thrombosis (DVT) and five of oral candidiasis. Pus swab grew Staphylococcous aureus in eight instances and Streptococcous pyogenes in four.Conclusion: Pyomyositis in HIV positive patients tends to occur at low CD4+ cell counts. Staphylococcus aureus was the most common causative organism. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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