Abstract :
Objective: Evaluation and management of Tuberculous Pyomyositis, a rare manifestation of Mycobacterium tuberculae.
Materials and Methods: All the patients who had visited the orthopaedic OPD at Mahamaya Rajkiya Allopathic Medical College Ambedkar Nagar during the period from March 2012 to March 2019 and diagnosis supported by radiological evaluation by MRI/USG and established by acid fast staining/histopathological evaluation of aspirate/biopsy of involved muscle.
Results: Depends upon their clinical presentation initially 28 cases were suspected among which 16 cases (57.10%) found positive for tuberculous pyomyositis. Two patients were lost during follow up so finally there were 14 cases (50%) included in this study. Among 14 cases, 7 cases (50%) were female and 7 cases (50%) male. The age of patients varied from 9 year to 68 year and the duration of illness on presentation from 2 months to 12 months. The routes of infection were hematogenous in 11 cases
(78.57%) and penetrating injury in 3 cases (21.42%). All cases were managed with anti tubercular drugs as per guideline, and surgery also needed in 8 cases (72.72%).
Conclusion: Isolated presentation of tuberculosis as pyomyositis is rare and not widely reported in the literature. Tuberculous pyomyositis should be considered in long standing vague swelling of the upper and lower limb without constitutional symptoms and signs of inflammations. Thus it is our recommendation is to establish the diagnosis of tubercular pyomyositis followed by anti tubercular treatment; and in selected cases surgical drainage and debridement along with ATT.
Keyword :
Pyomyositis, Tubercular, Muscle, Infection.