Doctors treat 10-year-old girl with pyomyositis

Seven surgeries later, the aspiring dancer is fine

03/03/2020, SPECIAL CORRESPONDENT,CHENNAI

From left, Dr. B. Vijayalakshmi, Dr. Satish Manivel, Dr. V. B. Narayanamurthy, Dr. Lakshmi Prashanth and Dr. Arul Mozhi Mangai with the 10-year-old on Monday. S. R. Raghunathan

A team of doctors of Kauvery Hospital treated a 10-year-old girl, who suffered from pyomyositis, a bacterial infection, and had complications including respiratory failure, acute kidney injury and sepsis.

Lakshmi Prashanth, consultant paediatrician, said the girl, an aspiring dancer, was treated in her native town for an ankle sprain with an above knee plaster cast. “However, five to seven days later, she had excruciating pain, swelling in the right lower limb and high grade fever. When she came to us, her presentation suggested deep vein thrombosis - a clot in the leg. She developed difficulty in breathing and normal urine output stopped. Her heart rate was high and blood pressure low,” she told reporters on Monday.

The girl’s total blood count was 49,000 to 50,000 signalling severe sepsis, she said, adding: “She needed critical care support. She had acute kidney failure. We provided respiratory support and put her on antibiotics.” The girl had certain skin changes suggesting infection in her right leg that was both limb and life threatening, the doctors said.

Plastic surgeons took her up for exploratory studies and found she suffered from severe pyomyositis. Tissues in the muscle around the bones were necrosed. For this, she underwent seven radical surgical procedures to remove the tissues. There was pus in the deep compartment of the leg, she said.

“We do see cases of pyomyositis but not as life threatening and limb threatening as this one. Usually, it occurs in immune-compromised patients such as elderly, HIV positive persons and those under chemotherapy for cancer. This was an otherwise healthy child,” she said.

V. B. Narayanamurthy, senior consultant-plastic surgeon, said that it was important to seek help early in such circumstances. “We have removed dead tissues and have preserved normal ones. She is able to walk now, and we are hoping that the muscles recover.”

Sathish Manivel, senior consultant-plastic surgeon, Vijayalakshmi B., senior consultant-infectious diseases and Sridhar N., senior consultant-intensivist, also spoke.