Pyomyositis in a 5-year-old child

We present a case of pyomyositis in an otherwise healthy 5-year-old child t hat underscores the potential for serious, life-threatening complications. Pyomyositis of the gluteal, psoas, and iliacus muscles was associated with osteomyelitis, septic arthritis, a large inferior vena cava thrombus, septi c pulmonary emboli, and eventual pneumonia. Primary pyomyositis is a purule nt infection of striated muscle thought to be caused by seeding from a tran sient bacteremia. The focal infection typically forms an abscess that gener ally responds to intravenous antibiotics and occasionally requires adjuncti ve computed tomography-guided aspiration and drainage. This localized infec tious process rarely produces further sequelae unless treatment is delayed. Pyomyositis is rare in healthy individuals and requires a high clinical su spicion in patients who present with fever, leukocytosis, and localized pai n.