J Korean Diabetes Assoc.  2006 Mar;30(2):140-144. 10.4093/jkda.2006.30.2.140.

A Case of Multifocal Pyomyositis in Diabetes Mellitus

• Park ES
• Kim JH
• Jung BY
• Park JH
• Ahn JH
• Lee JY
• Hwang SH
• Lee KW
• Han JK
• Mok JO
• Kim YJ
• Park HK
• Kim CH
• Kim SJ
• Byun DW
• Suh KI
• Yoo MH

• KMID: 2063444
• DOI: http://doi.org/10.4093/jkda.2006.30.2.140

Abstract

Pyomyositis is an acute bacterial infection of skeletal muscle, usually caused by Staphylococcus aureus. It is common in the tropics but rare in temperate climates. In temperature climate there are predisposing factors, such as diabetes, HIV infection, malignancy. The incidence of reported bacterial pyomyositis is increasing in recently, especially among immunocompromised persons such as HIV infection or diabetes mellitus. We experience multifocal pyomyositis in 49-year-old man with type 2 diabetes mellitus presented with drowsy mental state. Muscular USG and MRI finding shows multifocal abscess in thigh. Blood culture revealed Staphyloccus aureus. And patient received a intravenous broad-spectrum antibiotics, incision and drainage. He was successfully managed with drainage and antibiotics then discharge. Since diabetes or infection with HIV predisposes patients to bacterial infection, pyomyositis will occur more frequently. Increased awareness if the disease will improve management.

Keyword

Diabetes mellitus; Pyomyositis

MeSH Terms

Abscess
Anti-Bacterial Agents
Bacterial Infections
Causality
Climate
Diabetes Mellitus*
Diabetes Mellitus, Type 2
Drainage
HIV
HIV Infections
Humans
Incidence
Magnetic Resonance Imaging
Middle Aged
Muscle, Skeletal
Pyomyositis*
Staphylococcus aureus
Thigh
Anti-Bacterial Agents

Figure

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  Fig. 1 Panel A(HAD #8) shows both lung infiltration and right pleural effusion. Panel B(HAD #20); After antibiotics application, both lung field infiltration was improved.

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  Fig. 2 Ultrasonography shows increased echogenicity and geographic peripheral marginal echogenic lesion in right thigh.

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  Fig. 3 MRI shows low signal intensity in right thigh mass in T1WI.

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  Fig. 4 MRI shows high signal intensity in T2WI.

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