PYOMYOSITIS - CLINICAL-FEATURES AND PREDISPOSING CONDITIONS

Objective. To describe the manifestations of nontropical pyomyositis a nd associated comorbid conditions that may predispose to pyomyositis. Methods. A retrospective review of 13 patients with pyomyositis seen a t our center including one illustrative case report. Reports of tropic al and nontropical pyomyositis were found by review of Index Medicus, Medline, and references from published cases and clinical review paper s. Results. All 13 patients had variable presentations including fever , muscle pain, tenderness, and swelling. Eleven patients had comorbid conditions that may have led to their infection, including one with hu man immunodeficiency virus and 3 with history of trauma. Staphylococcu s aureus was found to be a causative organism in 7 patients, 2 patient s had multiple organisms isolated, and 2 had no organisms isolated. El even patients had successful treatment with intravenous antibiotics an d either computerized tomographic scan guided percutaneous or open ope rative drainage. Conclusion. Onset of pyomyositis is usually insidious , with progression to purulent collections. Comorbid conditions likely predispose patients to pyomyositis and may contribute to delay in dia gnosis and treatment. Increased awareness of this disease, especially in an immunosuppressed patient, should lead to earlier diagnosis and t reatment with improved outcomes.