Pyomyositis in Children: Report of Four Cases

小兒化膿性肌炎：四病例報告

廖璽璸(Shii-Ben Liaw) ； 邱世昌(Shr-Chang Chyou) ； 高信安(Hsin-An Kao) ； 洪漢陽(Han-Yang Hong) ； 李宏昌(Hung-Chang Lee)

《Acta Paediatrica Sinica》 29卷5期 (1988/10) Pp. 335-340

摘要

膿性肌炎為好發於熱帶地區的疾病，約佔其外科住院病例3%~4%之多，故又名熱帶性肌炎，而在台灣則屬罕見。本文報告1984年8月至1986年8月於馬偕醫院小兒科發現的4例化膿性肌炎。病人年齡分佈在4歲到9歲之間，3名為女童。兩例以右上腹疼痛腫塊表現並伴有發燒，初診診斷為原因不明肝腫大。另兩例以大腿腫塊表現且不良於行，其中一例病發前一星期曾遭踢傷並有發燒，此二者初診時即懷疑為化膿性肌炎，腿部X光除軟組織腫大外，腿骨無任何變化。四例之腫塊局部變化均表現出木頭般的硬度而無紅、熱、波動等現象。住院當天超音波檢查即發現肌肉層有低廻音區，膿液抽吸培養為金黃色葡萄球菌，血液培養則無細菌生長。在化膿性肌炎的診斷下，立即給予oxacillin靜脈注射7天至10天不等。癒後均良好並無復發。我們建議對於有上述腫塊的病人宜作超音波檢查，以據此作膿液抽吸，可獲得迅速的診斷與治療。

並列摘要

Pyomyositis is a common disease in the tropics, and yet it is rarely reported in Taiwan. Four cases in whom pyomyositis was diangosed at Mackay Memorial Hospital from August 1984 to August 1986 are being presented. Patients' age varied from 4 years old to 9 years old, and three of them were girls. Two cases came to hospital with the chief complaints offender right upper quadrant abdominal mass; the other two cases had complaints of mass of thigh muscle and with limitation of movement. All the mass lesions had no inflammatory signs and were characterized as firm, tender, not warm, not fluctuant, and not erythematous. The former two were initially diagnosed as hepatomegaly with an unknown nature. With the aid of ultrasound and its characteristic echolucence image in muscle layers, pyomyositis was promptly diagnosed and confirmed later with needle aspiration. Pyomositis remains a rarity in Taiwan and has no characteristic symptoms and signs, so the application of ultrasonography to any suspected lesion can help to establish early diagnosis.

並列關鍵字

Pyomyositis ； Ultrasonography