Muscle Abscesses Due to Infections: Don't Ignore

This article is professionally consulted by Master, Doctor Le Duong Tien - General Internal Medicine Doctor - Department of Medical Examination & Internal Medicine - Vinmec Danang International General Hospital. Dr. Tien has many years of experience in musculoskeletal medicine.

Infectious muscle abscess is one of the common medical infections today, caused by inflammation of the rhabdomyolysis under the invasion of certain bacteria. Although it does not directly affect the patient's life, an infectious muscle abscess needs to be diagnosed and treated as quickly as possible to avoid unwanted complications.

Muscle abscess is a condition in which the skeletal muscle tissue is damaged, forming pus-filled sacs here, causing some symptoms of clinical infection and usually occurs after the patient has an infectious disease in the skin or skin. There is a wound on the body. Muscle abscess is caused by a variety of bacteria, the most common of which is Staphylococcus aureus, but it can also be some other bacterial agents such as streptococcus, pneumococcus, meningococcus, gonococcal... Infectious muscle abscesses can occur anywhere in the body, and are usually only present in a single muscle, which is more likely to occur in patients with the disease. bacteremia. In particular, for patients with certain medical conditions related to a weakened immune system in the body, a muscle abscess due to an infection can occur in many muscles.
Most typically, the lumbosacral abscess usually occurs in patients with a history of previous urogenital tract infections, or in patients who have undergone surgery. abdomen, with tuberculosis or other pyogenic bacteria. Some clinical symptoms of lumbosacral abscess that often appear in patients are lower rib pain, inability to extend the leg on the side where the lumbosacral muscles are inflamed, and when performing a hip examination, No abnormalities were found in the hip joint.

Some of the most typical manifestations on common types of muscle abscesses in patients are:
Stage 1 - 2 weeks first: The muscle is swollen, when pressed, the muscle density is firm, with or without the condition. redness, the patient may experience mild pain. Stage 2-4 weeks later: The muscles begin to swell clearly, the patient feels very painful, when pressing on the muscle, there is a feeling of swelling, when performing the aspiration procedure, pus appears. End stage: At this time, complications of muscle abscess such as skin abscess or septic shock may occur in the patient. In addition, the patient may present with the following symptoms of infection syndrome:
High fever from 39°C to 40°C, the nature of the fever is usually continuous and fluctuating. The patient showed signs of weakness and fatigue. Patients present with dry lips, dirty tongue, and other signs of infection.

In addition to the clinical signs, the patient is also performed a number of laboratory tests to help support the diagnosis, including:
Peripheral blood cell analysis: white blood cell count may increase, in which accounted for the majority of neutrophils, erythrocyte sedimentation rate increased, CRP index increased, Fibrinogen increased, Globulin and Procalcitonin increased. In some cases, blood cultures will give positive results. The patient is indicated to aspirate fluid from the muscle abscess to conduct testing, there may be the presence of highly degenerated neutrophils, or this fluid can also be taken for culture. Visceral smear or PCR test for tuberculosis for differential diagnosis. Muscle ultrasound is done to investigate problems such as whether the volume of the muscle is increased due to infection or not, whether the muscle structure is changed... X-ray: evaluate the state of bone inflammation, inflammation of the membranes. accompanying bone, or lumbosacral and air bubbles in patients with lumbosacral abscess. If an infected muscle abscess is caused by tuberculosis bacteria, X-ray images of calcified calcifications of the abscess may be obtained. Computed tomography: Helps detect muscle abscesses early because it allows exploration of locations that other imaging techniques cannot penetrate. Magnetic resonance imaging: Usually indicated in the pathology of lumbosacral abscess.

The main principles when treating pathological bacterial abscesses are:

Antibiotics to treat muscle abscess must be applied early, in high doses, administered intravenously and must be used for a full time from 4 to 6 weeks. The choice of the best antibiotic is based on the results of the culture of the fluid as an antibiotic. Some ways to use antibiotics in the treatment regimen for muscle abscesses are as follows:
The first antibiotic when treating muscle abscesses should be thought of as an antibiotic against Staphylococcus aureus, if there are clinical signs of resistance. The drug can be changed to the antibiotic vancomycin. In immunocompromised patients, broad-spectrum antibiotics should be used to kill Gram-negative bacilli as well as anaerobic bacteria, typically a combination of vancomycin with an antibiotic of the Carbapenem group or Piperacillin. . In cases where it is determined that the cause of the infectious muscle abscess is anaerobic bacteria, the antibiotic of choice in treatment may be clindamycin. In addition to medical treatment with antibiotics, it is possible to apply along with aspiration technique to drain pus from the muscle abscess. A needle or surgery can be used to drain the abscess. In addition to palliative treatment, a care regimen is needed to improve the patient's overall condition and prevent possible septic shock.
Infectious muscle abscess is an infectious disease in the muscle, which can lead to sepsis, septic shock and even death in some cases when the disease is too advanced. The disease has risk factors that need to be avoided to reduce the likelihood of getting the disease, and when there are symptoms of the disease, it is necessary to immediately go to a reputable medical facility for examination, diagnosis and treatment within a short period of time. as soon as possible.
Vinmec International General Hospital is the address for examination, treatment and prevention of diseases. When performing the examination process at Vinmec, customers will be welcomed and used modern facilities and equipment along with perfect medical services under the guidance and advice of experts. Good doctors, well-trained both at home and abroad.
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