Nontropical pyomyositis: Analysis of eight patients in an urban center

Nontropical pyomyositis is rare and usually associated with immunodeficienc y virus (HIV) infection. This study assessed manifestations and response to treatment of nontropical pyomyositis in an area with a high prevalence of HIV seropositivity, We undertook a chart review of eight consecutive patien ts treated for pyomyositis-primary infection of skeletal muscles-from 1988 through 1998, All patients complained of myalgia; four (50%) had fever and six (75%) had leukocytosis, Muscles involved were deltoid, quadriceps, glut eus, and psoas, Six (75%) patients had identifiable risk factors for pyomyo sitis: HIV seropositivity (two), history of intravenous drug abuse tone), c hronic paraplegia and malnutrition tone), diabetes and chronic renal failur e tone), and leukemia tone). One patient had had streptococcal pharyngitis previously but was otherwise healthy; another, a 2-year-old, had no evidenc e of underlying disease, Staphylococcus aureus was the most common organism isolated (50%), Four patients were treated with incision and drainage plus antibiotics; the remaining four patients were treated with intravenous ant ibiotics only; all recovered. Nontropical pyomyositis, which is often assoc iated with HIV seropositivity or chronic illness, has a favorable outcome. Treatment can be effective even without surgical intervention.