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Published on: July 1, 2020
Pyomyositis and Infectious Myositis: A Comprehensive, Single-Center Retrospective Study
Christopher Radcliffe1, Savanah Gisriel2, Yu Si Niu1
1Yale University School of Medicine, New Haven, Connecticut, USA.
Background:
Pyomyositis is a bacterial infection of skeletal muscle that classically leads to abscess formation. A related, but distinct, entity is infectious myositis. The epidemiology of these infections has changed in recent years.
Methods:
To better characterize both pyomyositis and infectious myositis, we conducted a retrospective study at our tertiary care institution. We identified 43 cases of pyomyositis and 18 cases of infectious myositis treated between January 2012 and May 2020.
Results:
The mean age of patients was 48 years, and 66% were male. Diabetes mellitus affected one third of patients, and 16% had other immunocompromising comorbidities. Staphylococcal species accounted for 46% of all infections, and common symptoms included muscle pain (95%) and subjective fever (49%). Altered mental status was a presenting symptom in 16% of cases. Approximately half of all patients received >1 class of antibiotic, and the median length of antimicrobial therapy was 18 days. Open and percutaneous drainage procedures figured prominently in the management of these infections, with 28% of patients requiring multiple procedures. Pathology specimens were available for 12 of 61 cases. Overall, the treatment success rate was 84%.
Conclusions:
Gram-positive bacteria accounted for most infections at our institution, and management commonly involved open or percutaneous drainage procedures. Future studies that prospectively evaluate treatment strategies for pyomyositis and infectious myositis are warranted.
Insights
Pyomyositis and infectious myositis are bacterial muscle infections. Management often requires antibiotics and drainage procedures, with Gram-positive bacteria being the most common cause.
Area of Science:
- Infectious Diseases
- Musculoskeletal Infections
Background:
- Pyomyositis is a bacterial skeletal muscle infection often causing abscesses.
- Infectious myositis is a related but distinct condition.
- Recent shifts in the epidemiology of these infections are noted.
Purpose of the Study:
- To characterize pyomyositis and infectious myositis.
- To analyze patient demographics, pathogens, symptoms, and treatment outcomes.
Main Methods:
- Retrospective study at a tertiary care institution.
- Inclusion of 43 cases of pyomyositis and 18 cases of infectious myositis.
- Data collection from January 2012 to May 2020.
Main Results:
- Mean patient age 48 years, 66% male; 33% had diabetes, 16% other comorbidities.
- Staphylococcal species caused 46% of infections; common symptoms were muscle pain (95%) and fever (49%).
- 84% treatment success rate; 28% required multiple drainage procedures.
Conclusions:
- Gram-positive bacteria are the primary cause of these infections.
- Management frequently involves antibiotics and surgical drainage.
- Prospective studies are needed to optimize treatment strategies.
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