PYOMYOSITIS CAUSED BY STAPHYLOCOCCUS-AURE US AND ACUTE-RENAL-FAILURE IN A PATIENT WITH INACTIVE RHEUMATOID-ARTHRITIS AND INFECTION OF AN ENDOPROTHESIS

We describe a 64-year-old patient with severe osteoarthritis of the hi p, inactive rheumatoid arthritis and acute renal failure. Two days aft er beginning of hemodialysis severe arthralgias, myalgias and myoglobi nuria occured. These symptoms were caused by a staphylococcus aureus i nduced pyomyositis with rhabdomyolysis in the extensors of both arms. Later an infection of the endoprothesis of the hip was detected. Treat ment with surgical drainage, antibiotics and aggressive fluid substitu tion resulted in restoration of renal function and healing of pyomyosi tis. Risk factors, aspects of differential diagnosis and problems of t reatment of pyomyositis, which is a very rare disease in Middle Europe , are discussed.