{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T02:12:47Z","timestamp":1762049567734,"version":"build-2065373602"},"reference-count":71,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T00:00:00Z","timestamp":1652054400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Pyomyositis (PM) is an infrequent but increasing bacterial infection of the skeletal muscle, with muscles of the pelvis and thigh frequently involved. The diagnosis is often challenging, especially when a deep muscle is affected. We present a single-center pediatric cohort affected by pelvic PM. A retrospective analysis was performed, including children admitted to Meyer Children\u2019s Hospital between 2010 and 2020. Demographic, anamnestic, clinical, laboratory, radiological and management data were collected. Forty-seven patients (range 8 days\u201316.5 years, 66% males) were selected. Pain (64%), functional limitations (40%) and fever (38%) were the most common presenting symptoms; 11% developed sepsis. The median time to reach the diagnosis was 5 days (IQR 3\u20139). Staphylococcus aureus was the most common organism (30%), Methicillin-Resistant S aureus (MRSA) in 14%. PM was associated with osteomyelitis (17%), arthritis (19%) or both (45%). The infection was multifocal in 87% of children and determined abscesses in 44% (40% multiple). Pelvic MRI scan, including diffusion-weighted imaging (DWI), always showed abnormalities when performed. Clinical and laboratory findings in pelvic PM are unspecific, especially in infancy. Nevertheless, the infection may be severe, and the suspicion should be higher. MRI is the most useful radiological technique, and DWI sequence could reveal insidious infections.<\/jats:p>","DOI":"10.3390\/children9050685","type":"journal-article","created":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T21:23:27Z","timestamp":1652131407000},"page":"685","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Pelvic Pyomyositis in Childhood: Clinical and Radiological Findings in a Tertiary Pediatric Center"],"prefix":"10.3390","volume":"9","author":[{"given":"Giulia","family":"Abbati","sequence":"first","affiliation":[{"name":"Paediatric Residency, Meyer Children\u2019s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy"},{"name":"Department of Health Sciences, University of Florence, Viale Pieraccini 24, 50139 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6615-4788","authenticated-orcid":false,"given":"Sarah","family":"Abu Rumeileh","sequence":"additional","affiliation":[{"name":"Paediatric Residency, Meyer Children\u2019s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy"},{"name":"Department of Health Sciences, University of Florence, Viale Pieraccini 24, 50139 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8108-7790","authenticated-orcid":false,"given":"Anna","family":"Perrone","sequence":"additional","affiliation":[{"name":"Radiology Unit, Meyer Children\u2019s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7912-3366","authenticated-orcid":false,"given":"Luisa","family":"Galli","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Florence, Viale Pieraccini 24, 50139 Florence, Italy"},{"name":"Infectious Disease Unit, Meyer Children\u2019s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Resti","sequence":"additional","affiliation":[{"name":"Paediatric Unit, Meyer Children\u2019s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1105-1500","authenticated-orcid":false,"given":"Sandra","family":"Trapani","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Florence, Viale Pieraccini 24, 50139 Florence, Italy"},{"name":"Paediatric Unit, Meyer Children\u2019s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1056\/NEJM197101282840407","article-title":"\u201cTropical\u201d pyomyositis. An unusual infection due to staphylococcus aureus","volume":"284","author":"Levin","year":"1971","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1056\/NEJM197104152841518","article-title":"Pyomyositis-tropical and nontropical","volume":"284","author":"Geelhoed","year":"1971","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1001\/archfami.9.7.653","article-title":"Pyomyositis in a 5-year-old child","volume":"9","author":"Romeo","year":"2000","journal-title":"Arch. Fam. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2277","DOI":"10.2106\/00004623-200212000-00024","article-title":"Primary pyomyositis","volume":"84","author":"Bickels","year":"2002","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e149","DOI":"10.1016\/j.ijid.2008.08.013","article-title":"Primary pyomyositis in a child","volume":"13","author":"Taksande","year":"2009","journal-title":"Int. J. Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/j.otsr.2017.12.005","article-title":"Primary pyomyositis in children","volume":"104","author":"Elzohairy","year":"2018","journal-title":"Orthop. Traumatol. Surg. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1007\/BF02792650","article-title":"Aetiologie der myositis acuta","volume":"22","author":"Scriba","year":"1885","journal-title":"Dtsch. Z. Chir."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1002\/bjs.18005022621","article-title":"Tropical skeletal muscle abscesses (pyomyositis tropicans)","volume":"50","author":"Ashken","year":"1963","journal-title":"Br. J. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/0002-9610(79)90158-2","article-title":"Pyomyositis. Review of 205 cases in 112 patients","volume":"137","author":"Chiedozi","year":"1979","journal-title":"Am. J. Surg."},{"key":"ref_10","first-page":"463","article-title":"Pyomyositis tropicans in Uganda","volume":"45","author":"Horn","year":"1968","journal-title":"East Afr. Med. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1097\/BPB.0b013e3280140548","article-title":"Primary pyomyositis in children: A retrospective analysis of 11 cases","volume":"16","author":"Ovadia","year":"2007","journal-title":"J. Pediatr. Orthop. B"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1097\/01241398-199903000-00002","article-title":"Pyomyositis in children and adolescents: Report of 12 cases and review of the literature","volume":"19","author":"Spiegel","year":"1999","journal-title":"J. Pediatr. Orthop."},{"key":"ref_13","first-page":"1064","article-title":"Nontropical pyomyositis: Analysis of eight patients in an urban center","volume":"66","author":"Hossain","year":"2000","journal-title":"Am. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1097\/00006454-200010000-00015","article-title":"Pyomyositis in children","volume":"19","author":"Gubbay","year":"2000","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1007\/s00247-005-0082-1","article-title":"Acute pyomyositis of the pelvis: The spectrum of clinical presentations and MR findings","volume":"36","author":"Karmazyn","year":"2006","journal-title":"Pediatr. Radiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1007\/s00264-009-0765-6","article-title":"Tropical primary pyomyositis in children of the UK: An emerging medical challenge","volume":"34","author":"Unnikrishnan","year":"2010","journal-title":"Int. Orthop."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e832","DOI":"10.3928\/01477447-20111021-07","article-title":"Primary pyomyositis of the pelvis in children: A retrospective review of 8 cases","volume":"34","author":"Bertrand","year":"2011","journal-title":"Orthopedics"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1007\/s00264-017-3746-1","article-title":"Pelvic pyomyositis in children: Changing trends in occurrence and management","volume":"42","author":"Kiran","year":"2018","journal-title":"Int. Orthop."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1038\/jp.2009.106","article-title":"Primary pelvic pyomyositis in a neonate","volume":"29","author":"Falesi","year":"2009","journal-title":"J. Perinatol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1097\/01241398-199503000-00002","article-title":"Usefulness of magnetic resonance imaging for the diagnosis of acute musculoskeletal infections in children","volume":"15","author":"Mazur","year":"1995","journal-title":"Pediatr. Orthop."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1007\/s11832-009-0206-5","article-title":"Imaging on pelvic pyomyositis in children related to pathogenesis","volume":"3","year":"2009","journal-title":"J. Child Orthop."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1016\/j.mri.2004.08.005","article-title":"Bacterial pyomyositis: MRI and clinical correlation","volume":"22","author":"Yu","year":"2004","journal-title":"Magn. Reson. Imaging"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/s10140-007-0593-1","article-title":"MR imaging findings of pyogenic bacterial myositis (pyomyositis) in patients with local muscle trauma: Illustrative cases","volume":"14","author":"Theodorou","year":"2007","journal-title":"Emerg. Radiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/S0720-048X(99)00108-4","article-title":"Magnetic resonance imaging of pyomyositis in 43 cases","volume":"35","author":"Soler","year":"2000","journal-title":"Eur. J. Radiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1097\/01241398-199903000-00005","article-title":"Peripelvic abscesses: A diagnostic dilemma","volume":"19","author":"Mormino","year":"1999","journal-title":"J. Pediatr. Orthop."},{"key":"ref_26","first-page":"120","article-title":"Multifocal streptococcal pyomyositis complicated by acute compartment syndrome: Case report","volume":"10","author":"Harrington","year":"2001","journal-title":"J. Pediatr. Orthop. B"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1186\/s13256-016-1158-2","article-title":"Pyomyositis is not only a tropical pathology: A case series","volume":"10","author":"Comegna","year":"2016","journal-title":"J. Med. Case Rep."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/INF.0000000000000470","article-title":"Increasing pyomyositis presenting among children in Queensland, Australia","volume":"34","author":"Moriarty","year":"2015","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_29","first-page":"404","article-title":"Contribution of imaging to the evaluation of pyomyositis","volume":"109","author":"Boniotti","year":"2005","journal-title":"Radiol. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"j2400","DOI":"10.1136\/bmj.j2400","article-title":"A young goalkeeper with buttock pain and fever","volume":"357","author":"Moressa","year":"2017","journal-title":"BMJ"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e795","DOI":"10.1097\/MPH.0000000000002029","article-title":"Pseudomonas aeruginosa Pyomyositis in a Child with Acute Lymphoblastic Leukemia: A Case Report and Review of Literature","volume":"43","author":"Migliarino","year":"2021","journal-title":"J. Pediatr. Hematol. Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e276","DOI":"10.1097\/INF.0000000000003113","article-title":"Primary Pyomyositis in Children is No More a Rare Condition: Presentation of 2 Clinical Cases","volume":"40","author":"Pedoto","year":"2021","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1007\/s00330-002-1585-x","article-title":"Ultrasound and MRI features of pyomyositis in children","volume":"13","author":"Trusen","year":"2003","journal-title":"Eur. Radiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1016\/S0140-6736(60)92303-5","article-title":"Natural history of treated and untreated patients with septicaemia","volume":"1","author":"Smith","year":"1960","journal-title":"Lancet"},{"key":"ref_35","first-page":"155","article-title":"Beitrage zur Kenntnis der sogenannten Myositis infectiosa","volume":"13","author":"Miyake","year":"1904","journal-title":"Mitt. Grenzgeb. Med. Chir."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1093\/tropej\/fmt005","article-title":"Tropical pyomyositis in children: 10 years experience of a tertiary care hospital in northern India","volume":"59","author":"Verma","year":"2013","journal-title":"J. Trop. Pediatr."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1086\/507637","article-title":"Infective pyomyositis and myositis in children in the era of community-acquired, methicillin-resistant Staphylococcus aureus infection","volume":"43","author":"Pannaraj","year":"2006","journal-title":"Clin. Infect. Dis."},{"key":"ref_38","first-page":"99","article-title":"Pyomyositis in childhood","volume":"83","author":"Aderele","year":"1980","journal-title":"J. Trop. Med. Hyg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1148\/radiology.197.1.7568838","article-title":"Pyomyositis: Characteristics at CT and MR imaging","volume":"197","author":"Gordon","year":"1995","journal-title":"Radiology"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1016\/j.nic.2011.07.011","article-title":"Pyomyositis","volume":"21","author":"Agarwal","year":"2011","journal-title":"Neuroimaging Clin. N. Am."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1093\/clind\/15.4.668","article-title":"Pyomyositis in North America: Case reports and review","volume":"15","author":"Christin","year":"1992","journal-title":"Clin. Infect. Dis."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1136\/archdischild-2019-317506","article-title":"A toddler with a persisting limp after a minor trauma","volume":"106","author":"Trombetta","year":"2021","journal-title":"Arch. Dis. Child Educ. Pract. Ed."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1111\/j.1651-2227.1995.tb13618.x","article-title":"Pyomyositis caused by vigorous exercise in a boy","volume":"84","author":"Jayoussi","year":"1995","journal-title":"Acta Paediatr."},{"key":"ref_44","first-page":"1734","article-title":"PM: Clinical features and predisposing conditions","volume":"24","author":"Patel","year":"1997","journal-title":"J. Rheumatol."},{"key":"ref_45","first-page":"286","article-title":"Impact of underlying diseases on the clinical characteristics and outcome of primary pyomyositis","volume":"41","author":"Chiu","year":"2008","journal-title":"J. Microbiol. Immunol. Infect."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.arcped.2005.11.021","article-title":"Paravertebral streptococcal myositis complicated by an epidural abscess in a 5-year-old girl","volume":"13","author":"Renoux","year":"2006","journal-title":"Arch. Pediatr."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1097\/01241398-199311000-00016","article-title":"Pyomyositis in children","volume":"13","author":"Renwick","year":"1993","journal-title":"J. Pediatr. Orthop."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1080\/02724939992347","article-title":"Pyomyositis in children: Analysis of 31 cases","volume":"19","author":"Ameh","year":"1999","journal-title":"Ann. Trop. Paediatr."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.1097\/PEC.0000000000001370","article-title":"Septic Arthritis, Osteomyelitis, and Pyomyositis in a Previously Healthy Infant","volume":"34","author":"Bline","year":"2018","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/s11908-016-0520-2","article-title":"Pyomyositis in Children","volume":"18","author":"Verma","year":"2016","journal-title":"Curr. Infect. Dis. Rep."},{"key":"ref_51","first-page":"158","article-title":"Primary haemophilus influenzae pyomyositis in an infant: A case report","volume":"45","author":"Toyran","year":"2003","journal-title":"Turk. J. Pediatr."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"44","DOI":"10.4103\/0022-3859.192799","article-title":"Salmonella pyomyositis with concurrent sacroiliac osteomyelitis presenting as piriformis syndrome: A rare case","volume":"63","author":"Phadke","year":"2017","journal-title":"J. Postgrad. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e142","DOI":"10.1097\/INF.0000000000001776","article-title":"Lemierre\u2019s Syndrome Presenting as Multifocal Pyomyositis in a Young Child","volume":"37","author":"Held","year":"2018","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1097\/MAJ.0b013e318157d3c7","article-title":"An unusual case of Lemierre\u2019s syndrome presenting as pyomyositis","volume":"335","author":"Mayer","year":"2008","journal-title":"Am. J. Med. Sci."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1016\/j.arcped.2012.09.001","article-title":"Primary meningococcal B osteomyelitis and arthritis with multifocal pyomyositis in a child: A case report","volume":"19","author":"Rousseau","year":"2012","journal-title":"Arch. Pediatr."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"ofw087","DOI":"10.1093\/ofid\/ofw087","article-title":"A Case of Meningococcal Pyomyositis in an Otherwise Healthy Adult","volume":"3","author":"Barakat","year":"2016","journal-title":"Open Forum Infect. Dis."},{"key":"ref_57","unstructured":"Davey, W.W. (1973). Companion to Surgery in Africa, Churchill Livingstone."},{"key":"ref_58","first-page":"49","article-title":"Pyomyositis","volume":"60","author":"Audran","year":"1993","journal-title":"Rev. Rheum."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1097\/01.pec.0000166728.86094.c9","article-title":"Pyomyositis. A fatal case in a healthy teenager","volume":"21","author":"Evans","year":"2005","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"S295","DOI":"10.1148\/radiographics.20.suppl_1.g00oc18s295","article-title":"Abnormal signal intensity in skeletal muscle at MR imaging: Patterns, pearls, and pitfalls","volume":"20","author":"May","year":"2000","journal-title":"RadioGraphics"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.cpradiol.2003.09.003","article-title":"Magnetic resonance imaging of osteoarticular infections in children","volume":"33","author":"Marin","year":"2004","journal-title":"Curr. Probl. Diagn. Radiol."},{"key":"ref_62","first-page":"667","article-title":"Magnetic resonance imaging of pyogenic myositis: A variety of findings","volume":"221","author":"Theodorou","year":"2001","journal-title":"Radiology"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1007\/BF00197058","article-title":"CT evaluation of soft tissue and muscle infection and inflammation: A systematic compartmental approach","volume":"24","author":"Beauchamp","year":"1995","journal-title":"Skelet. Radiol."},{"key":"ref_64","first-page":"35","article-title":"18F-FDG PET and PET\/CT in Fever of Unknown Origin","volume":"48","author":"Meller","year":"2007","journal-title":"J. Nucl. Med."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1007\/s00259-020-04707-z","article-title":"Role of FDG-PET\/CT in children with fever of unknown origin","volume":"47","author":"Pijl","year":"2020","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.cpet.2018.08.008","article-title":"Pediatric Musculoskeletal Imaging: The Indications for and Applications of PET\/Computed Tomography","volume":"14","author":"Khalatbari","year":"2019","journal-title":"PET Clin."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"22","DOI":"10.4103\/1450-1147.98741","article-title":"(18)F-FDG Positron Emission Tomography in Multifocal Pyomyositis","volume":"11","author":"Harisankar","year":"2012","journal-title":"World J. Nucl. Med."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/s00330-001-1164-6","article-title":"Ultrasound of muscles","volume":"12","author":"Peetrons","year":"2002","journal-title":"Eur. Radiol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1007\/s00256-011-1106-6","article-title":"Diffusion-weighted imaging (DWI) in musculoskeletal MRI: A critical review","volume":"40","author":"Khoo","year":"2011","journal-title":"Skelet. Radiol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1007\/s00330-016-4372-9","article-title":"Role of Diffusion Weighted Imaging in Musculoskeletal Infections: Current Perspectives","volume":"27","author":"Kumar","year":"2016","journal-title":"Eur. Radiol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1590\/S0102-36162010000300007","article-title":"Open drainage versus percutaneous drainage in the treatment of tropical pyomyositis. Prospective and randomized study","volume":"45","author":"Palacio","year":"2010","journal-title":"Rev. Bras. Ortop."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/5\/685\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:08:05Z","timestamp":1760137685000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/5\/685"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,9]]},"references-count":71,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["children9050685"],"URL":"https:\/\/doi.org\/10.3390\/children9050685","relation":{},"ISSN":["2227-9067"],"issn-type":[{"type":"electronic","value":"2227-9067"}],"subject":[],"published":{"date-parts":[[2022,5,9]]}}}