Deri ve yumuşak doku enfeksiyonları sınıfına giren, pürülan enfeksiyon miyoziti eskiden sadede tropikal bölgelerden bildirilmiş olduğundan, tropikal miyozit olarak tanımlanan bir hastalıktı. Ayrıca önceleri olguların genç erkeklerde gelişen bir hastalık olduğu düşünülmekteydi. Ancak hastalık farkındalığının artması ile farklı teoriler ortaya çıkmış ve dünya genelinde ve tüm yaş gruplarından (çocuklar ve yaşlılar dahil) olgular bildirilmiştir. Bu hastalık çizgili kasların inflamasyonudur. Primer veya sekonder olarak gelişebilir. En sık etkeni cilt flora üyesi olan Staphylococcus aureus olup, immunsupresif olgularda veya sekonder olgularda çok farklı etkenlerin bu hastalığa sebep olduğu bildirilmiştir. Bu derleme çalışmasında, pürülan enfeksiyöz miyozite neden olan çeşitli patojenler, tanı ve tedavi yöntemleri tartışılmaktadır.

/pdf/purulan-enfeksiyoz-miyozit-e0gbpqpj.pdf

Pürülan enfeksiyöz miyozit

Necrotizing fasciitis of the thigh secondary to perforated rectal cancer: the sciatic foramen as a route for infective spread

Necrotizing fasciitis (NF) is a potentially life-threatening surgical emergency. It is a rapidly progressive infection of soft tissues, and mortality is related to the degree of sepsis and the general condition of the patient. It is a rare condition that requires a rapid diagnosis and surgical treatment is aggressive debridement. There are a small number of reported cases of perforation of a rectal malignancy leading to NF of the thigh. We present a case with rectal cancer in which the sciatic foramen had provided a channel for the spread of pelvic infection into the thigh.

Fascitis necrotizante del muslo secundaria a cáncer de recto perforado: el agujero ciático como vía de diseminación infecciosa

A 53-year-old male patient who underwent a rectal cancer operation nine years ago was evaluated with complaints of pain and swelling in the lateral thigh. Radiological imaging revealed abscess foci in the right thigh muscles. Surgical drainage and debridement were performed but developed recurrence. Contrast-enhanced abdominal tomography was performed due to a positive medical history and it was seen that an enterocutaneous fistula was formed from the anastomosis site of previous cancer surgery to both sides of the thigh. Bilateral thigh abscesses were drained and radical debridement was performed in the same session with surgery for the fistula. Pathological examination of the surgical specimens showed no evidence of cancer and the patient was discharged on the 14th postoperative day with complete resolution of the infection. Hip abscesses are rare, delays in the diagnosis and treatment of the underlying cause in cases of abscess secondary to abdominal or pelvic pathologies lead to an increase in mortality. Therefore, it should be kept in mind that thigh abscesses may be another side of the coin besides being seen as an isolated infection. 

Bilateral Thigh Abscess Due to Rectal Fistula: A Rare Case Report With Silent Clinical
Presentation

Purulent myositis is an acute, intramuscular bacterial infection involving abscess formation most commonly affecting the quadriceps, hamstring and gluteal muscles. We present a case of extensive purulent myositis of the thigh and lower leg caused by bowel perforation below the peritoneal reflection secondary to rectal cancer. Cases of lower limb and perineal purulent myositis should raise suspicion of rectal perforation and should prompt investigations to exclude rectal malignancy.

/pdf/purulent-myositis-of-the-thigh-as-a-presentation-of-158b8xgw0i.pdf

Purulent myositis of the thigh as a presentation of perforated low rectal cancer.

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Purulent myositis of the thigh as a presentation of perforated low rectal cancer.