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Intercostal Muscle Abscesses in Infective Endocarditis Associated With Migratory Deposition of Calcium Pyrophosphate

Yuko Nakayama1, Ryuichi Ohta2, Naoto Mouri2

  • 1Family Medicine, Shimane University Faculty of Medicine, Izumo, JPN.

Cureus
|February 24, 2022
PubMed

Insights

Staphylococcus aureus infective endocarditis can cause severe complications, including rare intercostal muscle abscesses. Calcium pyrophosphate crystal deposition may increase susceptibility to these infections.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Musculoskeletal System

Background:

  • Infective endocarditis (IE) involves vegetations on heart valves and intima, often caused by bacteria like Staphylococcus aureus.
  • Staphylococcus aureus endocarditis is aggressive, leading to valve destruction, abscesses, and septic emboli to organs.
  • Common complications include heart failure, perivalvular abscesses, and seeding to the brain, kidneys, spleen, and lungs.

Observation:

  • Superficial muscle abscesses from S. aureus bacteremia are uncommon.
  • Calcium pyrophosphate crystal deposition near joints can predispose muscles to pseudo-abscess formation.
  • A case of IE with intercostal muscle abscesses due to S. aureus bacteremia in an 86-year-old man is presented.

Findings:

  • S. aureus bacteremia can lead to abscess formation in superficial muscles, such as the intercostal muscles.
  • Concurrent bloodstream infection and calcium pyrophosphate deposition in muscles around joints can trigger abscess formation.
  • IE requires careful follow-up due to the potential for diverse abscess locations.

Implications:

  • This case highlights the importance of considering unusual abscess sites in S. aureus IE.
  • Understanding the role of calcium pyrophosphate deposition may improve diagnosis and management of muscle abscesses in IE patients.
  • Further research into risk factors and clinical manifestations of S. aureus IE complications is warranted.
Keywords:
bacteremiabacterialcalcium pyrophosphateendocarditisintercostal musclesstaphylococcus aureus

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