Abstract
A 74-year-old woman with a 20-ear history of type 2 diabetes mellitus admitted for back pain, fever, and a diabetic ulcer of the first right toe was found in abdominal computed tomography (CT) to have an abscess in the bilateral psoas muscle.She also reported pain in her left elbow, from which pus was aspirated.The bilateral psoas abscess was incised under general anesthesia, the left elbow was drained surgically, and the first and second toes were amputed, but she remained febrile and reported increasing pain and swelling of the buttocks and bilateral thighs.CT at these sites showed fluid collection, so the gluteal muscles and bilateral thighs were incised and drained.Postoperatively, her symptoms and clinical signs improved, and she was discharged after rehabilitation, walking with a prosthesis.
Pyomyositis should be considered in the differential diagnosis of any immunocompromised subjects with myalgia and fever.We hope that an increased awareness of pyomyositis will improve management of this disease.
