Bacterial pyomyositis in the United States

Area of Science:

• Infectious Diseases
• Immunology
• Public Health

Background:

• Bacterial pyomyositis incidence is increasing, notably in immunocompromised populations.
• Human immunodeficiency virus (HIV) infection is a significant factor in pyomyositis cases.
• Underlying conditions like diabetes and malignancy are common in non-HIV pyomyositis patients.

Purpose of the Study:

• To review global cases of pyomyositis in HIV-infected individuals.
• To analyze pyomyositis cases in HIV-negative individuals in the United States since 1981.
• To compare pyomyositis characteristics between HIV-infected and HIV-negative patients, and across different geographic regions.

Main Methods:

• Systematic review of reported pyomyositis cases.
• Inclusion criteria: HIV-infected patients worldwide and HIV-negative patients in the US since 1981.
• Data analysis focused on patient demographics, comorbidities, causative organisms, clinical presentation, and outcomes.

Main Results:

• Among HIV-infected patients, pyomyositis often occurred in those with end-stage acquired immunodeficiency syndrome during the combination antiretroviral therapy era.
• Non-HIV-infected patients frequently had underlying conditions (diabetes, malignancy, rheumatologic disease), increasing risks of gram-negative infections, multifocal involvement, and higher mortality.
• Cases in temperate regions showed higher rates of immunocompromised individuals compared to tropical regions, a trend that may shift with the HIV epidemic.

Conclusions:

• Bacterial pyomyositis presents differently in HIV-infected versus HIV-negative individuals, influenced by immune status and comorbidities.
• Understanding these differences is crucial for timely diagnosis and effective management of pyomyositis.
• The epidemiology of pyomyositis is evolving, influenced by HIV prevalence and advances in treatment.