Primary Pyomyositis of the Adductor and Pectineus Muscle in Patients With Uncontrolled Diabetes: Report of Two Cases
Shuichi Miyamoto1, Yuichi Yoshii1, Kazumasa Watanabe1
1Department of Orthopedic Surgery, Tokyo Medical University Ibaraki Medical Center, Ami-machi, Ibaraki, Japan, tokyo-med.ac.jp.
Abstract:
Muscle amyotrophy and infarction are known to be rare complications of patients with diabetes mellitus and poor glycemic control. However, primary pyomyositis, an especially rare infection of the primary muscles, is also a problem that cannot be ignored. Primary pyomyositis typically begins as a subacute condition and is probably due to transient bacteremia. Here, we report on two patients with Type 2 diabetes mellitus and poor glycemic control who developed primary pyomyositis, which manifested as abscesses of the adductor and pectineus muscles. Both patients underwent surgical drainage, and one patient additionally underwent internal fixation while receiving a continuous local antibiotic perfusion. Both patients were well and without signs of recurrence at their final follow-up visit. Primary pyomyositis, in addition to muscle amyotrophy and infarction, should be included in the differential diagnosis of infections occurring in patients with painful lesions in the lower extremities and Type 2 diabetes mellitus with poorly controlled glycemia.
Insights
Primary pyomyositis is a rare muscle infection that can occur in patients with Type 2 diabetes and poor glycemic control. Early diagnosis and treatment, including surgical drainage, are crucial for recovery.
Area of Science:
- Infectious Diseases
- Endocrinology
- Musculoskeletal System
Background:
- Diabetes mellitus, particularly with poor glycemic control, is associated with rare complications like muscle amyotrophy and infarction.
- Primary pyomyositis, a bacterial infection of skeletal muscle, is an uncommon but significant complication, often arising from transient bacteremia.
Purpose of the Study:
- To report two cases of primary pyomyositis in patients with Type 2 diabetes and poor glycemic control.
- To highlight the importance of considering primary pyomyositis in the differential diagnosis of lower extremity infections in diabetic patients.
Main Methods:
- Case report of two patients with Type 2 diabetes mellitus and primary pyomyositis.
- Clinical presentation, diagnosis, and management including surgical drainage and antibiotic therapy.
Main Results:
- Two patients with Type 2 diabetes and poor glycemic control developed primary pyomyositis presenting as adductor and pectineus muscle abscesses.
- Both patients successfully recovered after surgical intervention and antibiotic treatment, with no signs of recurrence.
Conclusions:
- Primary pyomyositis should be considered in the differential diagnosis of painful lower extremity lesions in patients with Type 2 diabetes and uncontrolled hyperglycemia.
- Prompt diagnosis and appropriate management, including surgical drainage and antibiotics, lead to favorable outcomes.
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