Thigh pyomyositis caused by group A streptococcus in an immunocompetent adult without any cause

Kensuke Minami,Ayako Kumabe,Masami Matsumura,Tsuneaki Kenzaka

doi:10.1186/s13104-016-2346-2

Abstract

BackgroundPyomyositis is typically caused by Staphylococcus aureus, and is rare in temperate climates, although its prevalence has been recently increasing. This infection often involves the thigh, and is associated with immunodeficiency.Case presentationWe report the case of a healthy 20-year-old Japanese woman who experienced a fever and continuous pain for several days. She was admitted to our hospital and was diagnosed with pyomyositis after we discovered an abscess between the muscles of her dorsal distal left thigh using computed tomography. This is a rare case of thigh pyomyositis, as it was caused by group A streptococcus and occurred in an immunocompetent adult from a temperate climate.ConclusionsOur review of the literature revealed that group A streptococcus pyomyositis typically occurs in temperate climates, among young adults without any underlying disease, and is associated with a poorer prognosis, compared to general pyomyositis. We suggest that pyomyositis should be considered when immunocompetent adults present with apparently idiopathic inflammatory muscle lesions.

Highlights

Pyomyositis is typically caused by Staphylococcus aureus, and is rare in temperate climates, its prevalence has been recently increasing
Our review of the literature revealed that group A streptococcus pyomyositis typically occurs in temperate climates, among young adults without any underlying disease, and is associated with a poorer prognosis, compared to general pyomyositis
We suggest that pyomyositis should be considered when immunocompetent adults present with apparently idiopathic inflammatory muscle lesions

Summary

Conclusions

We encountered a rare and apparently idiopathic case of non-tropical pyomyositis that was caused by GAS in a healthy young Japanese woman. GAS pyomyositis typically occurs in temperate climates, among young adults without underlying disease, and is associated with a poorer prognosis, compared to general pyomyositis. The patient exhibited minor swelling, redness, and warmth in her thigh, and we were able to rapidly diagnose pyomyositis based on our physical findings and the CT results This rapid diagnosis allowed us to quickly start antibiotic treatment and drainage, which are both critical for treating pyomyositis (except during the early stage) [30]. Our review of the literature revealed that GAS pyomyositis typically occurs in temperate climates, among young adults without any underlying disease, and is associated with a poorer prognosis, compared to general pyomyositis.

Background

Findings