Pyomyositis: tropical disease in a temperate climate

Two cases of pyomyositis or bacterial abscess of striated muscle in adults are presented. One patient was initially diagnosed as having acute thrombophlebitis of the lower extremity. Computerized tomography was helpful in establishing the correct diagnosis. The other patient presented with a closed compartment syndrome following blunt trauma. Both patients responded to open drainage and antibiotic therapy, although the diagnosis was delayed for over three weeks in one patient. Although common in the tropics, pyomyositis is unusual in the temperate zone. Unfamiliarity with this entity remains the major obstacle to appropriate management.