Primary pyomyositis and disseminated septic pulmonary emboli: a reactivated staphylococcal infection?

Area of Science:

• Infectious Diseases
• Microbiology
• Immunology

Background:

• Staphylococcal pyomyositis is a serious soft tissue infection with significant mortality.
• It is increasingly diagnosed in non-tropical regions.
• Predisposing factors usually include skin breaches or weakened immunity.

Observation:

• A 59-year-old immunocompetent woman presented with primary, community-acquired iliopsoas muscle pyomyositis.
• The infection rapidly progressed, causing septic pulmonary emboli within 24 hours of admission.
• Computed tomography-guided drainage and cultures confirmed methicillin-susceptible Staphylococcus aureus.

Findings:

• The patient had no apparent predisposing factors for infection.
• A history of staphylococcal osteomyelitis in the same region 53 years prior was noted.
• Reactivation of the latent staphylococcal infection was hypothesized as the cause.

Implications:

• This case suggests that staphylococcal infections can remain latent for decades.
• Further research is needed to understand the mechanisms of reactivated staphylococcal infections.
• Clinicians should consider latent infections in atypical presentations, even without current risk factors.