title: Pyomyositis in the upper Negro river basin, Brazilian Amazonia.
abstract: Pyomyositis remains poorly documented in tropical Latin America. We therefore performed a retrospective review of cases admitted to a hospital in the upper Negro river basin during 2002-2006. Seasonality was assessed by the cosinor model and independent predictors of outcome were identified by logistic regression. Determinants of time-to-fever resolution were analysed using Cox regression. No seasonal trend was observed (p=0.284) among 82 hospitalised patients. The disease predominated in young males and the most commonly affected part of the body was the lower limb (68 [63.5%] out of 107 lesions). Staphylococcus aureus was the only identified infecting organism (18 of 20 culture results, 90%). Complications occurred in 17 patients (20.7%) and the case fatality rate was 2.4%. Children were more likely to present with eosinophilia than adults (OR= 4.20, 95% CI 1.08-16.32, p=0.048), but no other significant differences regarding clinical presentation and outcomes were observed. The time-to-fever resolution was the only independent determinant of poor outcome (OR=1.52, 95% CI 1.22-1.92, p<0.001) and was significantly longer in patients treated with combined antibiotic therapy than in those treated with single antibiotics (HR=0.523, 95% CI 0.296-0.926, p=0.026). Further studies to determine the best antibiotic therapy modality for the treatment of pyomyositis are required.
authors: Infectious Diseases Service, Teaching Hospital, Federal University of Minas Gerais, Belo Horizonte, Avenida Alfredo Balena 110, 30130100, Brazil. adb@cphiv.dk
authors: Alvaro H D
authors: AH
authors: Borges
authors: Brian
authors: B
authors: Faragher
authors: David G
authors: DG
authors: Lalloo
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000740:Anemia / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology*; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology; D016015:Logistic Models; D008297:Male; D052880:Pyomyositis / Q000150:complications* / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology; D012189:Retrospective Studies; D045483:Rivers / Q000382:microbiology; D012621:Seasons; D017678:Sex Distribution; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology; D013211:Staphylococcus aureus / Q000472:pathogenicity*; D013997:Time Factors; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents