Bacterial pyomyositis: MRI and clinical correlation
Journal
Magnetic Resonance Imaging
Journal Volume
22
Journal Issue
9
Pages
1233-1241
Date Issued
2004
Author(s)
Abstract
To characterize the findings of magnetic resonance imaging (MRI) of bacterial pyomyositis (PM) and correlate these data with the clinical information. Eighty-one patients were diagnosed with PM in our institute between 1997 and 2003. Of these, 40 patients (21 male, 19 female; mean age, 53 years) also underwent MRI examination. The clinical manifestation underlying medical problems and the characteristics of MRI were analyzed. Thirty of the patients received surgical intervention or image-guided drainage/aspiration of the abscess along with administration of antibiotics, while the remaining 10 patients were promptly treated solely with antibiotics. Thirty-one of 40 patients had underlying medical problems. These involved diabetes mellitus (DM, n=16), malignancies including cervical cancer, prostate cancer, non-Hodgkin's lymphoma and acute lymphocytic leukemia (n=10, one case also had DM), autoimmune disease or asthma with long-term steroid usage (n=4, one case also had DM), liver cirrhosis (n=2) and chronic renal insufficiency (n=1). Four patients had no abscess formation at presentation (invasive or early purulent stage), while the remaining 36 cases presented with at least one abscess (purulent stage). Patients older than 40 years or DM patients tended to have larger abscess(s) (P<.05). Gadolinium-enhanced images demonstrated either thick (n=12) or thin rim enhancement (n=24) of the abscess wall. For those 10 patients promptly treated solely with antibiotics, nine demonstrated thin rim enhancement of the abscess (P<.05). Magnetic resonance imaging plays an important role in the early recognition of bacterial PM. By precisely demarcating the extent of the disease, MRI can allow planning prompt antibiotic treatment combined with or without interventional procedures. ? 2004 Elsevier Inc. All rights reserved.
SDGs
Other Subjects
antibiotic agent; corticosteroid; gadolinium; acute lymphocytic leukemia; adult; aged; allergic asthma; antibiotic therapy; article; aspiration; autoimmunity; child; clinical feature; comorbidity; corticosteroid therapy; diagnostic imaging; drain; early diagnosis; female; human; image analysis; image enhancement; kidney failure; liver cirrhosis; major clinical study; male; medical examination; non insulin dependent diabetes mellitus; nonhodgkin lymphoma; nuclear magnetic resonance imaging; priority journal; prostate carcinoma; pyomyositis; uterine cervix carcinoma; Bacteria (microorganisms)
Type
journal article