scholarly journals Bronchitis obliterans after severe pneumonia in children: a review of 34 cases

2021 ◽  
Author(s):  
Rui Zhou ◽  
Jihong Dai
Keyword(s):  
Clinical Manifestations ◽  
Severe Pneumonia ◽  
Etiologic Agent ◽  
Interventional Treatment ◽  
Pulmonary Atelectasis ◽  
Effective Measure ◽  
Lung Inflation ◽  
Adenovirus Pneumonia ◽  
Mucosal Erosion ◽  
Medical University

Abstract Background: This study aimed to describe the clinical characteristics, pathogeny and bronchoscopic findings of 34 children with bronchitis obliterans after severe pneumonia. Methods: Thirty-four children diagnosed with bronchitis obliterans were retrospectively studied at the Children’s Hospital of Chongqing Medical University in China between January, 2014 and October, 2020. The clinical manifestations, pathogeny, lung computed tomography imaging and bronchoscopic findings of the 34 children were reported. Results: In children with bronchitis obliterans, repeated coughing, fever, wheezing, tachypnea, and lung rales were common clinical manifestations. Mycoplasma pneumoniae (M. pneumoniae) was the most common etiologic agent, followed by adenovirus. The CT scan images included uneven lung inflation(12/34), lung consolidation( 27/34), pulmonary atelectasis(23/34), and pleural effusion(22/34). All children underwent flexible bronchoscopy, and major types of airway findings were identified: mucosal congestion, luminal longitudinal folds, mucosal erosion or necrosis, hyperplastic changes, sputum emboli, bronchiectasis and obliterative-like lesions. Conclusion: In conclusion, severe M. pneumoniae pneumonia and adenovirus pneumonia appeared to have a higher risk of development of bronchitis obliterans. Bronchoscopy can be used as the main criterion for the diagnosis of bronchitis obliterans. Bronchoscopy interventional treatment is an effective measure to quickly recanalize the occluded lumen, but there is a risk of recurrence after treatment. Children with severe pneumonia should undergo regular follow-up and bronchoscopy to detect possible lumen occlusion in time.

scholarly journals Evaluation of Risk Factors for Exacerbations in Children with Adenoviral Pneumonia

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Na Xu ◽  
Peng Chen ◽  
Ying Wang
Keyword(s):  
Risk Factors ◽  
Disease Severity ◽  
Clinical Manifestations ◽  
Severe Pneumonia ◽  
Clinical Implications ◽  
Laboratory Findings ◽  
Severe Group ◽  
Adenovirus Pneumonia ◽  
The Difference ◽  
D Dimer

Purpose. The aim of this work was to analyze clinical features and laboratory findings of children with adenovirus pneumonia and guide clinical diagnosis, treatment, and assessment of disease severity. Material and Methods. Retrospective analysis of clinical data of 285 children with adenoviral pneumonia who were hospitalized in Wuhan Children’s Hospital from December 2018 to October 2019. According to the assessment criteria for severe pneumonia, it was divided into the severe group (92 cases) and the nonsevere group (193 cases). Collected clinical manifestations, complications, and laboratory test indicators in two groups of children and conducted all statistical analyses. Results. The risk of fever and wheezing was significantly higher in the severe group than in the nonsevere group. The difference was statistically significant (P<0.05). The risk of complications in the severe group was significantly higher than that in the nonsevere group. The difference was statistically significant (P<0.05). The levels of AST, LDH-L, PCT, ferritin, and D-dimer in the severe group were significantly higher than those in the nonsevere group. The difference was statistically significant (P<0.05). Conclusion. Children with severe adenovirus pneumonia have severe clinical manifestations and many complications. AST, LDH-L, PCT, ferritin, and D-dimer levels have important clinical implications for assessing disease severity.

scholarly journals Analysis of clinical characteristics of severe pertussis in infants and children: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Caiying Wang ◽  
Huimin Zhang ◽  
Yanlan Zhang ◽  
Lin Xu ◽  
Min Miao ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Clinical Characteristics ◽  
Severe Disease ◽  
Severe Pneumonia ◽  
Infants And Children ◽  
Critically Ill Children ◽  
Young Infants ◽  
Incidence And Mortality ◽  
Increasing Trend ◽  
Medical University

Abstract Background The incidence of pertussis shows an increasing trend in recent years, but some clinicians often lack sufficient understanding of the clinical characteristics and risk factors for severe pertussis, and more effective measures should be taken to reduce the incidence and mortality of pertussis in young infants Methods A retrospective study was conducted, and 184 infants and children with pertussis who had been hospitalized in the Department of Pediatrics of Beijing Ditan Hospital affiliated with Capital Medical University from January 2016 to December 2017 were included. Clinical data of the patients were collected and the clinical characteristics were statistically analyzed Results Among the 184 patients, 41.85% were infants < 3 months of age, and 65.22% of the total patients were not vaccinated against pertussis. There were 22 critically ill children, among whom 4 died, and compared with mild cases, they had a higher proportion of children younger than 3 months of age and infants not vaccinated against pertussis (63.64% vs. 38.89% and 100% vs. 60.49%, respectively); a higher proportion of children with severe pneumonia (100% vs. 0%); higher leukocyte count(× 109/L , 35.80 ± 20.53 vs 19.41 ± 8.59); and a higher proportion of children with severe hyperleukocytosis (18.18% vs. 0%, respectively) (P<0.05) Conclusions 1. Infants aged <3 months not vaccinated for pertussis appear more likely to become infected and have more severe disease. 2. Severe pneumonia and hyperleukocytosis are the main mechanisms underlying severe pertussis.

scholarly journals Adenovirus viremia may predict adenovirus pneumonia severity in immunocompetent children

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruimu Zhang ◽  
Hongmei Wang ◽  
Shufeng Tian ◽  
Jikui Deng
Keyword(s):  
Risk Factors ◽  
Viral Load ◽  
Disease Severity ◽  
Mycoplasma Pneumoniae ◽  
Quantitative Polymerase Chain Reaction ◽  
Univariate Analysis ◽  
Clinical Manifestations ◽  
Pneumonia Severity ◽  
Adenovirus Pneumonia ◽  
Blood Viral Load

Abstract Background Previous studies have demonstrated an association between adenovirus viremia and disease severity in immunocompromised children. However, few studies have focused on this association in immunocompetent children. This study explored the association between adenovirus viremia and adenovirus pneumonia severity in immunocompetent children. Methods We performed a retrospective, observational study of immunocompetent children with adenovirus pneumonia admitted to Shenzhen Children’s Hospital in Shenzhen, China. Pneumonia was classified as severe or mild based on the Chinese guideline for the classification of pneumonia severity. Serum samples from all the children included in the study were tested for adenovirus DNA with a quantitative polymerase chain reaction. Clinical manifestations, laboratory examinations, and disease severity were compared between children with severe and mild pneumonia. Results A total of 111 immunocompetent children with adenovirus pneumonia (60 severe, 51 mild) were included. The median age was 40 months, and 64 patients were male. Five patients were admitted to the intensive care unit, and two underwent endotracheal intubation. All patients were discharged after recovery or improvement. Univariate analysis and binary logistic regression analysis showed that leukocytosis (OR = 1.1; 95% CI: 1.0 to 1.2; P = 0.033), co-infection with Mycoplasma pneumoniae (OR = 5.0; 95% CI: 2.1 to 12.3; P <  0.001), and high blood viral load (OR = 1.5; 95% CI: 1.2 to 2.0; P = 0.001) may be risk factors for severe adenovirus pneumonia. Conclusions Leukocytosis, co-infection with Mycoplasma pneumoniae, and high blood viral load may be risk factors for severe adenovirus pneumonia in immunocompetent children. Blood viral load may predict pneumonia severity.

Effectiveness of protected aminopenicillins in treatment of non-social pneumonia in children

2021 ◽  
Author(s):  
Е.Е. Краснова ◽  
В.В. Чемоданов ◽  
Е.Г. Кузнецова
Keyword(s):  
Viral Infections ◽  
Respiratory Infections ◽  
Acquired Resistance ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Severe Pneumonia ◽  
Physical Symptoms ◽  
Community Acquired Pneumonia ◽  
Natural Activity ◽  
Respiratory Viral Infections

Пневмония – острое инфекционно-воспалительное заболевание легких преимущественно бактериальной этиологии, характеризующееся выраженной в разной степени дыхательной недостаточностью, токсическими и респираторными нарушениями, локальными физикальными симптомами, а также инфильтративными изменениями на рентгенограмме. Заболеваемость внебольничными пневмониями повышается в октябре-декабре, достигая максимума в январе-апреле, коррелируя с сезонным повышением уровня острых респираторных вирусных инфекций. Схожесть симптомов дебюта пневмонии с проявлениями острых респираторных вирусных инфекций может привести к несвоевременной ее диагностике и, как следствие, к отсроченному началу лечения. Поэтому в период сезонной заболеваемости респираторными инфекциями должна повышаться настороженность врачей-педиатров в отношении внебольничной пневмонии. Антибактериальная терапия оказывает решающее влияние на прогноз пневмонии, поэтому при достоверном диагнозе или у больного в тяжелом состоянии с вероятным диагнозом ее следует начать незамедлительно. Выбор антибиотика в каждом случае внебольничной пневмонии проводят индивидуально с учетом природной активности препаратов в отношении предполагаемого возбудителя и их возможной приобретенной резистентности, тяжести и течения заболевания, наличия у пациента противопоказаний к использованию тех или иных антибиотиков. В статье приводятся сведения о диагностических критериях внебольничных пневмоний. Рассмотрены вопросы антибактериального лечения типичной нетяжелой пневмонии у детей разных возрастных групп амоксициллином с клавулановой кислотой и показана его эффективность. Результаты проведенного исследования позволяют заключить, что пероральное использование одного курса защищенного аминопенициллина эффективно при лечении типичной внебольничной нетяжелой пневмонии у детей разного возраста, о чем свидетельствует ликвидация основных клинических проявлений болезни в короткие сроки. Pneumonia is an acute infectious and inflammatory lung disease of predominantly bacterial etiology, characterized by respiratory failure, toxic and respiratory disorders, local physical symptoms, and infiltrative changes on the roentgenogram. The incidence of community-acquired pneumonia increases in October-December, reaching a maximum in January-April, correlating with the seasonal increase in the level of acute respiratory viral infections. The similarity of the symptoms of the onset of pneumonia with the manifestations of acute respiratory viral infections can lead to its untimely diagnosis and, as a consequence, to a delayed start of treatment. Therefore, during the period of seasonal morbidity with respiratory infections, the alertness of pediatricians in relation to community-acquired pneumonia should increase. Antibiotic therapy has a decisive influence on the prognosis of pneumonia, therefore, with a reliable diagnosis or in a patient in serious condition with a probable diagnosis, it should be started immediately. The choice of antibiotic in each case of community-acquired pneumonia is carried out individually, taking into account the natural activity of the drugs in relation to the alleged pathogen and their possible acquired resistance, the severity and course of the disease, the patient's contraindications to the use of certain antibiotics. The article provides information on the diagnostic criteria for community-acquired pneumonia. The issues of antibacterial treatment of typical non-severe pneumonia in children of different age groups with amoxicillin with clavulanic acid are considered and its effectiveness is shown. The results of the study allow us to conclude that the oral use of one course of protected aminopenicillin is effective in the treatment of typical community-acquired non-severe pneumonia in children of different ages, as evidenced by the elimination of the main clinical manifestations of the disease in a short time.

scholarly journals Seroprevalence of toxoplasmosis in Vojvodina

2010 ◽  
Vol 138 (5-6) ◽  
pp. 333-336 ◽  
Author(s):  
Snezana Brkic ◽  
Gorana Gajski ◽  
Mirjana Bogavac ◽  
Daniela Maric ◽  
Vesna Turkulov ◽  
...  
Keyword(s):  
Toxoplasma Gondii ◽  
General Population ◽  
Pregnant Women ◽  
Acute Infection ◽  
Clinical Manifestations ◽  
Congenital Toxoplasmosis ◽  
Reproductive Age ◽  
Female Population ◽  
Effective Measure ◽  
Female Patients

Introduction Toxoplasmosis is an acute infectious anthropozoonotic disease with mild asymptomatic clinical manifestations in immunocompetent persons and more severe in immunocompromised patients. Acute infection in pregnancy can result in severe congenital toxoplasmosis with severe sequels. Objective Aims of study were to detect Toxoplasma gondii seroprevalence in general population of Vojvodina, Serbia, differences between genders and determination of seroprevalence in women of reproductive age and pregnant women. Methods Our retrospective study was conducted from 2006 to 2008 including 625 immunocompetent patients, hospitalized or observed as outpatients at the Clinical Centre of Vojvodina, Novi Sad. We performed commercial ELISA kits SERION - ELISA classic test by VIRION for the presence of specific IgG and IgM antibodies. According to seroepidemiological aim of the study, our results were presented only in qualitative values. Results We observed 173 male and 452 female patients. Seroprevalence in general population of Vojvodina was 38.1%. In male population seroprevalence was 45.7%, and in female population it was 35.2%, the difference which was statistically significant (p<0.05). Seroprevalence increased with age and seroconversion was detected to occur in persons aged about 20 years. In all female patients, 353 (78.1%) were in reproductive age with seroprevalence of 30%. In 161 pregnant women seroprevalence was 31.7%. Conclusion In this study we screened actual seroepidemiological situation to Toxoplasma gondii in Vojvodina, thus giving a contribution to the continuous epidemiological screening done in this region and in the country. According to our results, almost 70% of women in reproductive age were sensitive to primary acute infection during further pregnancies, which is highly important for the prevention of congenital toxoplasmosis. Although not routinely conducted in many countries, routine serological testing to Toxoplasma gondii in pregnant women and their education about preventive measures against this infection could be an effective measure in the future.

scholarly journals Maternal and perinatal characteristics and outcomes of pregnancies complicated with COVID-19 in Kuwait

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Amal Ayed ◽  
Alia Embaireeg ◽  
Asmaa Benawadh ◽  
Wadha Al-Fouzan ◽  
Majdeda Hammoud ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Live Birth ◽  
Gestational Age ◽  
Clinical Manifestations ◽  
Severe Pneumonia ◽  
Intrauterine Fetal Death ◽  
Nasopharyngeal Swab ◽  
The Public ◽  
Fluctuating Course ◽  
Gestational Age At Birth

Abstract Background The effect of SARS-CoV-2 infection in pregnant women and newborns is incompletely understood. Preliminary data shows a rather fluctuating course of the disease from asymptomatic or mild symptoms to maternal death. However, it is not clear whether the disease increases the risk of pregnancy-related complications. The aim of the study is to describe the maternal and neonatal clinical characteristics and outcome of pregnancies with SARS-CoV-2 infection. Methods In this retrospective national-based study, we analyzed the medical records of all pregnant women infected with SARS-CoV-2 and their neonates who were admitted to New-Jahra Hospital (NJH), Kuwait, between March 15th 2020 and May 31st 2020. During the study period and as part of the public health measures, a total of 185 pregnant women infected with SARS-CoV-2, regardless of symptoms, were hospitalized at NJH, and were included. Maternal and neonatal clinical manifestations, laboratory tests and treatments were collected. The outcomes of pregnancies included miscarriage, intrauterine fetal death (IUFD), preterm birth and live birth were assessed until the end date of the outcomes follow-up (November 10th 2020). Results A total of 185 pregnant women infected with SARS-CoV-2 were enrolled with a median age of 31 years (interquartile range, IQR: 27.5–34), and median gestational age at diagnosis of SARS-CoV2 infection was 29 weeks (IQR: 18–34). The majority (88%) of these women had mild symptoms, with fever (58%) being the most common presenting symptom followed by cough (50.6%). At the time of the analysis, out of the 185, 3 (1.6%) of the pregnant women had a miscarriage, 1 (0.54%) had IUFD which was not related to COVID-19, 16 (8.6%) had ongoing pregnancies and 165 (89%) had a live birth. Only 2 (1.1%) of these women developed severe pneumonia and required intensive care. A total of 167 neonates with two sets of twins were born with median gestational age at birth was 38 (IQR: 36–39) weeks. Most of the neonates were asymptomatic, and only 2 of them tested positive on day 5 by nasopharyngeal swab testing. Conclusions In this national-based study, most of the pregnant women infected with SARS-CoV-2 showed mild symptoms. Although mother-to-child vertical transmission of SARS-CoV-2 is possible, COVID-19 infection during pregnancy may not lead to unfavorable maternal and neonatal outcomes.

scholarly journals Etiologic Spectrum of Intestinal Obstruction in Ningxia District: A Retrospective Analysis of 4908 Cases in a 10-Year Period

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Wei Jiang ◽  
Wenyan Li ◽  
Qian Hao ◽  
Yuping Yao ◽  
Yajun Li ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Bowel Obstruction ◽  
Clinical Manifestations ◽  
Therapeutic Interventions ◽  
Malignant Bowel Obstruction ◽  
Increasing Trend ◽  
Adhesive Intestinal Obstruction ◽  
Adhesive Obstruction ◽  
Medical University ◽  
Overall Mortality

Background. Economic disparity contributes to the variation of intestinal obstruction (IO) etiologic spectrum. Clarifying the etiology distribution in local regions can help to unravel IO and promote early diagnosis, henceforth making sure standardized therapeutic interventions. Methods. Medical data of 4908 inpatients diagnosed with IO admitted to the General Hospital of Ningxia Medical University between January 2004 and December 2013 were recruited and analyzed retrospectively. The associated profiles included demographic features, clinical manifestations, and previous therapeutic operations. Results. 4908 cases of intestinal obstruction were identified during the period of study. It denoted that the hospitalization rate of IO has maintained upward momentum; the top four causes of IO were adhesion, tumor, intussusception, and hernias. These covered up nearly 80% of the total constitution. Among them, adhesive intestinal obstruction accounted for 45.17%, malignant bowel obstruction for 21.09%, intussusception for 8.72%, and hernia for 4.73%; abdominal surgery constituted for the majority (78.62%) of adhesive obstruction. The followed up analysis also found that appendectomy accounted for the biggest percentage, 28% of operation cases. Malignant bowel obstruction can have a rate of 96.43% in 1035 cases led by tumor lesions. Of which, the primary intestinal malignant tumor accounted for 68.64% and metastatic tumors for 31.36%. Nearly 50% occurred in the large intestine. The overall mortality of all 4908 cases was 4.7%. Conclusion. The hospitalizations of IO delineated an increasing trend. Adhesion was the main etiology in IO. The odds of malignant bowel obstruction was increasing in the proportion of IO. There were some differences towards the etiologic spectrum compared with western countries.

Clinical Characterization of Staphylococcus Septicemia-Associated Hemophagocytic Lymphohistiocytosis

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4905-4905
Author(s):  
Hongxia Qiu ◽  
Meng Song ◽  
Fang Ni ◽  
Jujuan Wang
Keyword(s):  
Bone Marrow ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Therapeutic Response ◽  
Gamma Globulin ◽  
Conflicts Of Interest ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Hepatic Function ◽  
Risk Of Death ◽  
Medical University

Abstract Abstract Objective: To analyze the epidemic characters, pathogenesis, clinical manifestations, laboratory data, therapeutic response, and prognosis in patients with staphylococcus septicemia-associated hemophagocytic lymphohistiocytosis(HLH). Methods A r Objective To analyze the epidemic characters, pathogenesis, clinical manifestations, laboratory data, therapeutic response, and prognosis in patients with staphylococcus septicemia-associated hemophagocytic lymphohistiocytosis(HLH). Methods: retrospective study was performed on 7 patients with staphylococcus septicemia-associated HLH who were admitted to The First Affiliated Hospital of Nanjing Medical University from January 2010 to December 2014. Results Seven out of 633patients(1.11%) with staphylococcus septicemia were confirmed to have HLH. The incidence of HLH in staphylococcus subspecies were:S.caprae, 12.50%;S.warneri, 12.50%;Methicillin-resistant Staphylococcusaureus(MRSA), 3.23%;S.hominis, 1.40%;S.haemolyticus, 1.25%;S.epidermidis, 0.59%, respectively. The main clinical manifestations included persistentfever(100%) and splenomegaly(85.71%). The most prominent laboratory abnormalities werehemocytopenia, abnormal hepatic function, and elevated ferritin. Bone marrow aspirations were performed on 6 patients and all of them hadhemophagocytosis shown in bone marrow smears. Among 7 patients, 4 patientssurvived(57.14%) and 3 patients died(42.86%). All the 4 cured patients were treated with antibiotic plus corticosteroid. And 2 of them used gamma globulin, while one used the COP chemotherapy regimen. Treatment with antibiotic plus corticosteroid was effective in our study. Conclusion Treatment with antibiotic plus corticosteroid was recommended for staphylococcus septicemia-associated HLH, and gamma globulin may also be useful in reducing the risk of death. Disclosures No relevant conflicts of interest to declare.

scholarly journals Nosocomial infections in children's wards

1940 ◽  
Vol 40 (6) ◽  
pp. 647-672 ◽  
Author(s):  
Joyce Wright
Keyword(s):  
Sore Throat ◽  
Otitis Media ◽  
Nosocomial Infections ◽  
Clinical Manifestations ◽  
College Hospital ◽  
Effective Measure ◽  
Slide Agglutination ◽  
Haemolytic Streptococcus ◽  
Agglutination Method ◽  
University College

1. During a period of 1 year the incidence of infection with haemolytic streptococci was determined among children on admission to, and during residence in, the children's wards of University College Hospital, London.2. The increased incidence among those in residence, 13·1% of whom acquired haemolytic streptococci during their stay, was due principally to outbreaks of infection by these organisms. By the slide agglutination method the majority of strains could be assigned to one or other of Griffith's thirty types and the presumed path of their spread studied.3. The source of the infection in most of the outbreaks was not ascertain-able from the data collected, but in general it did not appear to be in the patients themselves.4. With a few exceptions, isolation by cubicles was an effective measure in preventing the spread of haemolytic streptococci.5. In general the haemolytic streptococci seemed to spread from patient to patient, though the exact mode of spread was not ascertained.6. The clinical manifestations of infection by any one type of haemolytic streptococcus was varied, e.g. wound suppuration, sore throat, pyrexia, otitis media. Many of the infections were “latent”.7. In addition to the haemolytic streptococcal outbreaks, there were two outbreaks of diphtheria (fifteen patients), two of Bact. sonnei dysentery (ten patients and one nurse), one of catarrhal jaundice (one patient and three nurses), six cases of intercurrent gastro-enteritis of infancy and one case of measles.8. In all, at least 104 (or 18·9%) of the 551 patients of these wards developed intercurrent infections, manifest or latent, during their stay in hospital.

scholarly journals Bacterial, Fungal, Parasitic, and Viral Myositis

2008 ◽  
Vol 21 (3) ◽  
pp. 473-494 ◽  
Author(s):  
Nancy F. Crum-Cianflone
Keyword(s):  
Clinical Presentation ◽  
Psoas Abscess ◽  
Trauma Surgery ◽  
Clinical Manifestations ◽  
Etiologic Agent ◽  
Muscle Involvement ◽  
Necrotizing Myositis ◽  
Acute Rhabdomyolysis ◽  
Group B ◽  
Immunocompromised Hosts

SUMMARY Infectious myositis may be caused by a broad range of bacterial, fungal, parasitic, and viral agents. Infectious myositis is overall uncommon given the relative resistance of the musculature to infection. For example, inciting events, including trauma, surgery, or the presence of foreign bodies or devitalized tissue, are often present in cases of bacterial myositis. Bacterial causes are categorized by clinical presentation, anatomic location, and causative organisms into the categories of pyomyositis, psoas abscess, Staphylococcus aureus myositis, group A streptococcal necrotizing myositis, group B streptococcal myositis, clostridial gas gangrene, and nonclostridial myositis. Fungal myositis is rare and usually occurs among immunocompromised hosts. Parasitic myositis is most commonly a result of trichinosis or cystericercosis, but other protozoa or helminths may be involved. A parasitic cause of myositis is suggested by the travel history and presence of eosinophilia. Viruses may cause diffuse muscle involvement with clinical manifestations, such as benign acute myositis (most commonly due to influenza virus), pleurodynia (coxsackievirus B), acute rhabdomyolysis, or an immune-mediated polymyositis. The diagnosis of myositis is suggested by the clinical picture and radiologic imaging, and the etiologic agent is confirmed by microbiologic or serologic testing. Therapy is based on the clinical presentation and the underlying pathogen.

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