Pyomyositis
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Revision as of 21:31, 13 July 2022 by Aidan (talk | contribs) (Created page with "=== Background === * Pus within an individual muscle group, often associated with tropical climates * Risk factors include tropical climates, HIV, diabetes mellitus * May have a firm woody feel * CK often normal ==== Microbiology ==== * Staphylococcus aureus in 90% * Group A Streptococcus and Enterobacterales are also possible === Investigations === * MRI establishes the diagnosis, though CT and US are useful * Get blood cultures (positive in 5-3...")
Background
- Pus within an individual muscle group, often associated with tropical climates
- Risk factors include tropical climates, HIV, diabetes mellitus
- May have a firm woody feel
- CK often normal
Microbiology
- Staphylococcus aureus in 90%
- Group A Streptococcus and Enterobacterales are also possible
Investigations
- MRI establishes the diagnosis, though CT and US are useful
- Get blood cultures (positive in 5-30%)
- Repeat imaging if persistently bacteremic in order to find other infections
Management
- Needs incision and drainage
- Vancomycin or cefazolin is appropriate empiric therapy
- Add Gram-negative coverage if immunocompromised or open trauma
- Adjust based on microbiology
- Duration is with IV until better and not bacteremic, then oral to complete 2-3 weeks
