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A case of group B streptococcal pyomyositis
S A Back1, T O'Neill, G Fishbein
1Department of Medicine, University of California, Irvine.
Abstract:
The group B streptococcus is an opportunistic pathogen that causes a variety of serious infections including bacteremias, puerperal sepsis, and neonatal meningitis. Group B streptococcal infections of muscle are rare. We report here an unusual case of group B streptococcal pyomyositis. Pyomyositis arises predominantly from infections caused by Staphylococcus aureus and, occasionally, Streptococcus pyogenes. Because of the rarity of pyomyositis in temperate climates, the common lack of localizing signs or symptoms, and the frequently negative blood cultures, considerable delay often precedes the diagnosis of pyomyositis; in fact, the infection has been initially misdiagnosed as muscle hematoma, cellulitis, thrombophlebitis, osteomyelitis, or neoplasm. Diagnosis may be greatly aided by radiologic techniques that can demonstrate the sites of muscle enlargement and the presence of fluid collections. The response to antibiotics is usually rapid, but resolution of the infection may require aspiration of deeply situated muscle abscesses. This report describes a diabetic patient with an unusual presentation of pyomyositis that mimicked an acute abdomen.
Insights
Group B Streptococcus rarely causes pyomyositis, a serious muscle infection. This case highlights an unusual presentation in a diabetic patient, emphasizing diagnostic challenges and the need for advanced imaging.
Area of Science:
- Infectious Diseases
- Bacteriology
- Clinical Case Reports
Background:
- Group B Streptococcus (GBS) is an opportunistic pathogen causing serious infections like meningitis and bacteremia.
- Muscle infections by GBS are rare, with pyomyositis typically caused by Staphylococcus aureus or Streptococcus pyogenes.
- Pyomyositis diagnosis is often delayed due to rarity, non-specific symptoms, and negative blood cultures, leading to misdiagnosis.
Observation:
- This report details an unusual case of GBS pyomyositis.
- The patient presented with symptoms that mimicked an acute abdomen.
- Radiologic techniques were crucial in identifying muscle enlargement and fluid collections.
Findings:
- Group B Streptococcus was identified as the causative agent of pyomyositis in this patient.
- The presentation was atypical, complicating the initial diagnostic process.
- Prompt antibiotic treatment led to a rapid response, though surgical aspiration was needed for deep abscesses.
Implications:
- This case underscores the importance of considering GBS as a potential cause of pyomyositis, even in unusual presentations.
- Awareness of GBS pyomyositis can improve diagnostic accuracy and reduce delays.
- Radiological imaging and appropriate antibiotic therapy are key to managing this rare infection effectively.