Infective Myositis

Myositis may also have an infective basis. Viral myositis has been recorded in association with influenza and picomavirus infections, particularly those due to viruses of the Coxsackie group, and HIV infection is an increasingly common cause of myositis seen in routine practice. Fungal, bacterial, and parasitic myositis is seen much more rarely in North America and Europe than in tropical parts of the world, but in these regions these forms of infective myositis constitute a significant problem. In any survey of inflammatory muscle disorders, it is also necessary to consider other inflammatory conditions which affect muscle indirectly, but do not cause myositis in the strict sense of the word. In this group are to be found various forms of arteritis and fascitis and granulomatous conditions such as sarcoidosis. 

Bacterial and viral myositis is well recognized as a clinical entity by muscle pathologists. The viruses most commonly involved appear to be the Coxsackie viruses, the arboviruses, influenza virus, and HIV, but the mechanism whereby the viral infection gives rise to the myositic syndrome is not known. A detailed discussion of such problems is presented later on pages 333-334. 

Portilla J +, Eur j Clin Microbiol Infect Dis 23(7), 580 Myalgia/Myositis/Myopathy/Myotoxicity (5%)... 

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B42. Brummelkamp, W. H., Hoogendijk, J. L., and Boerema, I., Treatment of anerobic infections (clostridial myositis) by drenching the tissues with oxygen under high atmospheric pressure. Surgery 49, 299-302 (1961). 

UNTOWARD EFFECTS Rifabutin generally is well tolerated in persons with HIV infection primary reasons for discontinuation of therapy include rash (4%), GI intolerance (3%), and neutropenia (2%). Overall, neutropenia occurred in 25% of patients with severe HIV infection who received rifabutin. Uveitis and arthralgias have occurred in patients receiving rifabutin doses >450 mg daily in combination with clarithromycin or fluconazole. Patients should be cautioned to discontinue the drug if visual symptoms occur. Like rifampin, the drug causes an orange-tan discoloration. Rarely, thrombocytopenia, a flu-like syndrome, hemolysis, myositis, chest pain, and hepatitis have occurred. 

Fish-handler s disease Rosenbach s erysipeloid with purplish red indurated plaque with central clearing Typically self limited Necrotizing myositis or soft tissue infection... 

Visruthan NK, Boo PK, Kader A, Ping CH, Ong C. Omeprazole-induced myositis in a child receiving triple therapy for Helicobacter pylori infection. J Pediatr Gastroenterol Nutr 2012 55 338-9. 

Cupler EJ, Leon-Monzon M, Miller J et al. (1996) Inclusion body myositis in HIV-I and HTLV-I infected patients. Brain 119, 1887-1893. 

Ozden S, Gessain A, Gout O, Mikol J. (2001) Sporadic inclusion body myositis in a patient with human T cell leukemia virus type 1-associated myelopathy. Clin Infect Disil, 510-514. 

Ozden S, Cochet M, Mikol J et al. (2004) Direct evidence for a chronic CDS -I- -T-cell-mediated immune reaction to tax within the muscle of a human T-cell leukemia/lymphoma virus type 1-infected patient with sporadic inclusion body myositis. J Virol 78, 10320-10327. 

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