Abdominal rectus muscle pyomyositis: Report of a case and review of the literature.

Tilemachos Fountoukis,Maria Tilkeridou,Pantelis Fytas,Ioannis Konstantinou,Ioannis Skandalos,Nikolaos Tsatsanidis

doi:10.4081/idr.2018.7522

Tilemachos Fountoukis, Maria Tilkeridou + Show 4 more

Open Access

https://doi.org/10.4081/idr.2018.7522

Copy DOI

Journal: Infectious disease reports	Publication Date: Mar 29, 2018
Citations: 8	License type: CC BY 4.0

Affiliation: Agios Pavlos General Hospital

Abstract

Pyomyositis is an uncommon primary bacterial infection of skeletal muscles, usually caused by Staphylococcus aureus. Predisposing factors for pyomyositis include immunodeficiency, trauma, injection drug use, concurrent infection and malnutrition. The diagnosis, staging of the disease and differential diagnosis are established by ultrasound, CT and MRI. Treatment involves surgical drainage and antibiotic therapy. We report a case of abdominal rectus muscle pyomyositis, which constitutes, as far as we know, the second reported in bibliography, while Prevotella disiens is firstly reported as causative agent.

Highlights

Pyomyositis is an uncommon primary bacterial infection of skeletal muscles, usually caused by Staphylococcus aureus.[1]
We report a case of abdominal rectus muscle pyomyositis, which constitutes, as far as we know, the second reported in bibliography.[6]
Due to the diagnosis of abdominal rectus muscle pyomyositis, the patient underwent a surgical drainage of the abscess

Summary

Introduction

Pyomyositis is an uncommon primary bacterial infection of skeletal muscles, usually caused by Staphylococcus aureus.[1]. The agent responsible can be isolated from blood cultures. An 81-year-old patient was admitted to our hospital emergency department with a gradually increasing, during the last 15 days, painful swelling in the lower abdomen at the right abdominal rectus muscle With clinical suspicion of incarcerated Spigelian hernia, the patient underwent abdominal and chest x-ray investigation, which were normal, and an abdominal CT scanning which revealed an abscess, with contrast agent-induced enhancing of the capsule as well as the internal diaphragms, inside the right abdominal rectus muscle below the umbilicus (Figure 2). Due to the diagnosis of abdominal rectus muscle pyomyositis, the patient underwent a surgical drainage of the abscess. The initial empiric antibiotic therapy was modified according to the results of the antibiogram (Table 1) and Amoxycillin/Clavunanic acid was administered orally, 1 g twice per day, for an additional 3 weeks.

Discussion

Conclusions