A case of pyomyositis due to Mycobacterium tuberculosis

17개월 여아에서 발견된 근육내 결핵 1례

  • Bae, Yun-Jin (Department of Pediatrics, College of Medicine, Dong-A University) ;
  • Choi, Jin-Sung (Department of Pediatrics, College of Medicine, Dong-A University) ;
  • Lee, Young Ah (Department of Pediatrics, College of Medicine, Dong-A University) ;
  • Kim, Sung-Soo (Department of Orthopedics, College of Medicine, Dong-A University) ;
  • Rha, Seo-Hee (Department of Pathology, College of Medicine, Dong-A University) ;
  • Jung, Jin-A (Department of Pediatrics, College of Medicine, Dong-A University)
  • 배윤진 (동아대학교 의과대학 소아과학교실) ;
  • 최진성 (동아대학교 의과대학 소아과학교실) ;
  • 이영아 (동아대학교 의과대학 소아과학교실) ;
  • 김성수 (동아대학교 의과대학 정형외과교실) ;
  • 나서희 (동아대학교 의과대학 병리학교실) ;
  • 정진아 (동아대학교 의과대학 소아과학교실)
  • Received : 2006.07.28
  • Accepted : 2006.08.28
  • Published : 2006.10.15

Abstract

Pyomyositis is a primary bacterial infection of the skeletal muscles. Although infection can affect any skeletal muscle, the large muscle groups such as the quadriceps or gluteal muscles are most often the focus of this disease, and most commonly the inflammation is focal, involving a single muscle. The mechanism of pyomyositis is poorly understood. The local mechanical trauma at the time of an incidental bacteremia is frequently postulated as a mechanism that could explain the high incidence of the disease in tropical areas and its male preponderance. Staphylococcus aureus is the most common organism responsible for pyomyositis. Mycobacterium tuberculosis primarily affects the lungs, and the prevalence of active pulmonary tuberculosis co-existing with musculoskeletal tuberculosis has been about 30 percent. We report here on a case of an otherwise healthy 17-month-old girl, who had tuberculous pyomyositis at the upper arm after the hepatitis A vaccination with no evidence of any coexistent active tuberculosis.

화농근육염은 골격근의 원발성 세균 감염으로, 주로 대퇴사두근이나 둔근에 발생한다. 화농근육염의 병리기전은 잘 알려져 있지 않으나 국소부위의 외상과 동반된 균혈증에 의한 것으로 설명되며, Staphylococcus aureus가 가장 흔한 원인균이다. Mycobacterium tuberculosis은 폐결핵을 일으키는 경우가 가장 흔하며, 활동성 폐결핵과 근골격계 결핵이 동반되는 경우는 약 30%이다. 근육내 결핵은 폐결핵을 일으키는 Mycobacterium tuberculosis가 근육 내로 침입하여 발병하는 것으로, 폐외 결핵 중 비교적 드문 형태이다. 저자들은 17개월 여아에서 다른 부위의 결핵을 동반하지 않은 근육내 결핵 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

Keywords

References

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