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Bacterial Pyomyositis in the Neck Due to Bacteroides Fragilis.
Kajal Dalal1, Christopher M Hernandez2, Evan Sanford3
1Otolaryngology, University of Texas Health Science Center, San Antonio, USA.
Cureus
|November 1, 2021
Summary
This case study details a rare instance of bacterial pyomyositis in the neck caused by Bacteroides fragilis, originating from a perforated colon. It underscores the need for thorough infection source evaluation in pyomyositis cases.
Area of Science:
- Infectious Diseases
- Microbiology
- Surgical Pathology
Background:
- Bacterial pyomyositis typically affects lower extremities, often caused by Staphylococcus aureus, and is more common in tropical regions.
- Neck pyomyositis is an uncommon presentation, posing diagnostic challenges.
- Identifying the source of infection is crucial for effective treatment and patient outcomes.
Observation:
- A 77-year-old male with diabetes presented with progressive bilateral neck swelling and reduced neck mobility.
- CT imaging revealed sternocleidomastoid and pectoralis major muscle abscesses, with mediastinal fluid collection.
- Abscess drainage and cultures confirmed Bacteroides fragilis infection.
Findings:
- Bacteroides fragilis, a gut bacterium, was identified as the causative agent of pyomyositis.
- Subsequent imaging identified a perforated ascending colon as the likely source of infection.
- This represents a rare documented case of gastrointestinal-derived pyomyositis.
Implications:
- Highlights the importance of considering atypical microbial sources in pyomyositis.
- Emphasizes the need for comprehensive evaluation to identify the origin of infection, especially from the gastrointestinal tract.
- Timely diagnosis and treatment of pyomyositis are critical to prevent sepsis and mortality.
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