San Cristóbal de La Laguna, España
El objetivo del presente trabajo es presentar el caso de un paciente de 76 años afecto de piomiositis no tropical, que desarrolló un cuadro de polineuropatía subaguda. la piomiositis es un proceso habitualmente restringido a los trópicos, aunque cada vez se describen más casos fuera del cinturón intertropical. El principal agente etiológico es el Staphylococcus aureus. La asociación de la piomiosistis con el síndrome de Guillain-Barré es excepcional, y ha sido reportado únicamente en un paciente afecto de piomiosistis por Staphylococcus aureus. En el caso que aquí presentamos se cultivó una Escherichia coli en uno de los abscesos musculares que presentó el paciente, quien desarrolló una polineuropatía subaguda con disociación albúmino-citológica en el líquido cefalorraquídeo, compatible con síndrome de Guillain-Barré, por lo que constituye el primer caso de Guillain-barré asociado a piomisitis por ese germen.
Non tropical pyomyositis is an uncommon disease, sometimes associated with other entities. Association with Guillain-Barré syndrome has been exceptionally reported. In this paper we present the case of a patient with non-tropical pyomyositis due to Escherichia coli who developed a subacute/acute demyelinating polyneuropathy.
A 76-year-old man was admitted with muscle inflammation affecting the right shoulder, an abscess spontaneously draining in the right armpit, and a suppurative collection in the left forearm. After successful treatment he was discharged from the hospital, but 45 days later he developed subacute polyneuropathy. When admitted for this second time, a muscle abscess in the right forearm was observed and pus cultures were positive for Escherichia coli. With antibiotics according to antibiogram the patient improved, and after proper nutrition and intravenous immunoglobulins, he recovered slowly from polyneuropathy. This case shows the association of pyomyositis due to E. coli and acute demyelinating neuropathy. To our knowledge, only one similar case was reported; in that case the etiologic agent was Staphylococcus aureus.
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