Tropical Pyomyositis: An Unusual Cause for Sepsis and Hip Pain in Adults the United Kingdom

Pyomyositis is a bacterial infection, commonly due to Staphylococcus aureus infection resulting in myositis on muscle biopsy and abscess formation in skeletal muscle. . Although often prefaced with the term '"tropical' tropical" alluding to its prevalence in tropical climates this disease does present, albeit rarely, in adult patients residing in temperate climates as well.

A 60 year -year-old woman living in the UK with no risk factors presented apyrexial with native left hip and thigh pain and was initially diagnosed with sciatica and discharged from the Emergency Department. She subsequently re-presented days later with worsening pain and inability to weight bear; blood tests showed she had worsening inflammatory markers. Her magnetic resonance imaging (MRI) scan showed a collection in the musculature of her left hip adductors. She was diagnosed with Pyomyositis. The collection was drained via ultrasound and she was treated with intravenous IV antibiotics, followed by oral antibiotics, and made a full recovery.

Our report highlights the need for thorough and complete investigation, including MRI scanning for patients with unclear causes of hip pain and raised inflammatory markers. It demonstrates how conditions such as pyomyositis can still arise outside the expected demographics and this could have been easily confused with a septic hip had she not undergone further imaging.