Pyomyositis in patients with diabetes. Computed tomography as a key to diagnosis

Pyomyositis rarely occurred in nontropical climates in the past but is becoming increasingly recognized in temperate climates. Nevertheless, this diagnostic possibility is often not immediately recognized. Pyomyositis should be considered in diabetic patients with lower-extremity cellulitis who do not respond to presumptively appropriate therapy. A high index of suspicion and documentation with appropriate imaging techniques, aggressive surgical intervention, and adjunctive antibiotic therapy are the keys to prompt resolution without sequelae. The patients in this report were diabetic adults who responded to appropriate therapy after computed tomographic scans, surgical exploration, and cultures established the diagnosis.