Rapidly-Progressing Pyomyositis After Chest Contusion in a Patient With Well-Controlled Diabetes Mellitus

Abstract

Pyomyositis is an uncommon acute bacterial infection of the skeletal muscle. It is sometimes referred to as "tropical pyomyositis" because it has been primarily reported as an endemic disease in tropical regions. In temperate climates, it is mainly diagnosed in immunocompromised persons, such as those with human immunodeficiency virus infection, malignancy, diabetes, and various other medical conditions. Early diagnosis and appropriate antimicrobial therapy for pyomyositis are important, however, it is often missed in its early stage. Herein, we report the case of a patient with obesity and well-controlled diabetes in whom rapid onset pyomyositis developed in only 2 days after chest contusion and induced bacteremia in its early stage. He was successfully treated by antimicrobials without any drainage or surgical intervention. Even in patients with well-controlled diabetes or in healthy persons, pyomyositis should be considered for patients who present with fever and muscle swelling and pain, especially when they have obesity and a history of blunt trauma. It should also be noted that pyomyositis, mimicking muscle contusion or hematoma can appear very early after blunt muscle trauma. Prompt diagnosis and antimicrobial treatment for pyomyositis can lead to a favorable outcome, without surgical drainage.