Pyomyositis in spinal cord injury patients

Bacterial infections remain a major cause of morbidity and mortality among patients with longstanding spinal cord injury. Infection may occur in a number of different foci, often taxing the skill of the most accomplished diagnostician. Herein are described three patients with fever of unknown origin wherein extensive diagnostic workups ultimately led to the diagnosis of primary pyomyositis. These patients demonstrate the importance of repeated careful physician examination in determining the site of infection in patients with established sensorimotor deficits. Although primary pyomyositis is not a common occurrence in those with spinal cord injuries, it should be included as a potential cause of fever in this patient population.