Pyomyositis in pediatrics: 10-year experience in a high-complexity pediatric hospital in Argentina

Abstract

Background: Pyomyositis is an acute-subacute bacterial infection of skeletal muscle. Aim: To estimate the incidence of pyomyositis in hospitalized patients, describe and identify risk factors for bacteremia and hospitalization, and evaluate differences between MSSA and MRSA. Methods: Descriptive, retrospective, observational study with patients aged 1 month to 18 years hospitalized between 1/1/8 and 12/1/18. Variables: sex, age, home overcrowding, previous injury, seasonality, anatomical location and images, previous antibiotherapy, clinical stage, laboratory, cultures and antibiogram, days of intravenous (IV) treatment, hospitalization, fever and bacteremia. Results: 188 patients were included. Incidence: 38.9 cases/10,000 admissions (95% CI 33.7 - 44.9). Days of hospitalization and IV treatment: 11 (RQ 8-15 and RQ 8-14, respectively). The development of bacteremia was associated with elevated CRP (p=0.03) and prolonged fever (p < 0.001). There were no differences in the evolution and laboratory parameters between MSSA and MRSA. Leukocytosis (p=0.004), neutrophilia (p=0.005), and bacteremia (p=0.001) were associated with a longer hospital stay. Conclusions: This study collects the experience of more than 10 years of hospitalized children diagnosed with pyomyositis and provides information on its characteristics. Parameters associated with bacteremia and hospital stay are described.