Fulminant pyomiositis

Sepsis in a young patient

Abstract

Pyomiositis is an infrequent infection of the skeletal muscle, that affects mainly young men, and not only in the tropical regions. It is usually caused by Staphylococcus aureus. This is a case of a 23 year old patient that came to consultation due to abdominal pain irradiating to the buttocks region producing gate disability. He referred history of piercing and the presence of an inguinal furuncle in regression. He was hemodinamically stable at the physical examination, slight fever, a piercing on the lower lip, abdominal pain at palpation and pain when moving the left hip. The first clinical diagnosis was septic arthritis for which management started; however the torpid evolution and the imaging tests concluded unspecific myositis and pulmonary metastasic abscess. Management in the intensive care unit was required with mechanical ventilation and broad spectrum antibiotics. Improvement with slow regression.