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Pyomyositis
Medical condition

Pyomyositis is a bacterial infection of the skeletal muscles which results in an abscess. Pyomyositis is most common in tropical areas but can also occur in temperate zones.

Pyomyositis can be classified as primary or secondary. Primary pyomyositis is a skeletal muscle infection arising from hematogenous infection, whereas secondary pyomyositis arises from localized penetrating trauma or contiguous spread to the muscle.

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Diagnosis

Diagnosis is done via the following manner:

  • Pus discharge culture and sensitivity
  • X ray of the part to rule out osteomyelitis
  • Creatinine phosphokinase (more than 50,000 units)
  • MRI is useful
  • Ultrasound guided aspiration

Treatment

The abscesses within the muscle must be drained surgically (not all patients require surgery if there is no abscess). Antibiotics are given for a minimum of three weeks to clear the infection.2

Epidemiology

Pyomyositis is most often caused by the bacterium Staphylococcus aureus.3 The infection can affect any skeletal muscle, but most often infects the large muscle groups such as the quadriceps or gluteal muscles.456

Pyomyositis is mainly a disease of children and was first described by Scriba in 1885. Most patients are aged 2 to 5 years, but infection may occur in any age group.78 Infection often follows minor trauma and is more common in the tropics, where it accounts for 4% of all hospital admissions. In temperate countries such as the US, pyomyositis was a rare condition (accounting for 1 in 3000 pediatric admissions), but has become more common since the appearance of the USA300 strain of MRSA.91011

Gonococcal pyomyositis is a rare infection caused by Neisseria gonorrhoeae.12

Additional images

  • Maravelas R, Melgar TA, Vos D, Lima N, Sadarangani S (2020). "Pyomyositis in the United States 2002-2014". J Infect. 80(5):497-503. doi:10.1016/j.jinf.2020.02.005. PMID 32147332.

References

  1. "Primary pyomyositis". UpToDate. Retrieved 6 March 2023. https://www.uptodate.com/contents/primary-pyomyositis ↩

  2. Pannaraj PS, Hulten KG, Gonzalez BE, Mason EO Jr, Kaplan SL (2006). "Clin Infect Dis". Clinical Infectious Diseases. 43 (8): 953–60. doi:10.1086/507637. PMID 16983604. https://doi.org/10.1086%2F507637 ↩

  3. Chauhan S, Jain S, Varma S, Chauhan SS (2004). "Tropical pyomyositis (myositis tropicans): current perspective". Postgrad Med J. 80 (943): 267–70. doi:10.1136/pgmj.2003.009274. PMC 1743005. PMID 15138315. http://pmj.bmjjournals.com/cgi/pmidlookup?view=long&pmid=15138315 ↩

  4. Pannaraj PS, Hulten KG, Gonzalez BE, Mason EO Jr, Kaplan SL (2006). "Clin Infect Dis". Clinical Infectious Diseases. 43 (8): 953–60. doi:10.1086/507637. PMID 16983604. https://doi.org/10.1086%2F507637 ↩

  5. Ovadia D, Ezra E, Ben-Sira L, et al. (2007). "Primary pyomyositis in children: a retrospective analysis of 11 cases". J Pediatr Orthop B. 16 (2): 153–159. doi:10.1097/BPB.0b013e3280140548. PMID 17273045. /wiki/Doi_(identifier) ↩

  6. Mitsionis GI, Manoudis GN, Lykissas MG, et al. (2009). "Pyomyositis in children: early diagnosis and treatment". J Pediatr Surg. 44 (11): 2173–178. doi:10.1016/j.jpedsurg.2009.02.053. PMID 19944229. /wiki/Doi_(identifier) ↩

  7. Small LN, Ross JJ (2005). "Tropical and temperate pyomyositis". Infect Dis Clin North Am. 19 (4): 981–989. doi:10.1016/j.idc.2005.08.003. PMID 16297743. /wiki/Doi_(identifier) ↩

  8. Taksande A, Vilhekar K, Gupta S (2009). "Primary pyomyositis in a child". Int J Infect Dis. 13 (4): e149 – e151. doi:10.1016/j.ijid.2008.08.013. PMID 19013093. https://doi.org/10.1016%2Fj.ijid.2008.08.013 ↩

  9. Pannaraj PS, Hulten KG, Gonzalez BE, Mason EO Jr, Kaplan SL (2006). "Clin Infect Dis". Clinical Infectious Diseases. 43 (8): 953–60. doi:10.1086/507637. PMID 16983604. https://doi.org/10.1086%2F507637 ↩

  10. Ovadia D, Ezra E, Ben-Sira L, et al. (2007). "Primary pyomyositis in children: a retrospective analysis of 11 cases". J Pediatr Orthop B. 16 (2): 153–159. doi:10.1097/BPB.0b013e3280140548. PMID 17273045. /wiki/Doi_(identifier) ↩

  11. Mitsionis GI, Manoudis GN, Lykissas MG, et al. (2009). "Pyomyositis in children: early diagnosis and treatment". J Pediatr Surg. 44 (11): 2173–178. doi:10.1016/j.jpedsurg.2009.02.053. PMID 19944229. /wiki/Doi_(identifier) ↩

  12. Jensen M (2021). "Neisseria gonorrhoeae pyomyositis complicated by compartment syndrome: A rare manifestation of disseminated gonococcal infection". IDCases. 23: e00985. doi:10.1016/j.idcr.2020.e00985. PMC 7695882. PMID 33294370. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7695882 ↩