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Nontropical pyomyositis in adults

J J Gomez-Reino¹, J J Aznar, J L Pablos

¹Unidad de Reumatologia, Hospital Doce de Octubre, Madrid, Spain.

Seminars in Arthritis and Rheumatism

|June 1, 1994

Summary

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Non-tropical pyomyositis (PMS) presents differently than tropical forms, affecting adults with underlying immune issues. Treatment involves drainage and antibiotics, but mortality remains at 10%.

Area of Science:

Infectious Diseases
Rheumatology
Epidemiology

Background:

Pyomyositis (PMS) is a primary striated muscle infection.
Emerging evidence suggests non-tropical PMS may differ clinically from tropical presentations.

Purpose of the Study:

To investigate and delineate the distinct clinical characteristics of non-tropical pyomyositis.
To compare non-tropical PMS with classical tropical pyomyositis.

Main Methods:

A retrospective review of 12 non-tropical PMS cases (1976-1992).
A pooled analysis of these cases with a comprehensive English literature search.
Inclusion of 97 patients in the final analysis.

Main Results:

Two age peaks (30-50 and 60-70 years) and a 3:1 male-to-female ratio were observed.

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Common symptoms included fever, elevated erythrocyte sedimentation rate, and muscle inflammation.

Staphylococci were the most common pathogens (61%), often associated with comorbidities like HIV and diabetes (66% of patients).

Thigh muscles were most frequently involved (54%).

Mortality rate was 10%, with variations based on comorbid conditions.

Conclusions:

Non-tropical pyomyositis exhibits distinct clinical features, microbial patterns, and demographic profiles compared to tropical pyomyositis.
Comorbidities significantly influence the presentation and outcomes of non-tropical pyomyositis.
Standard treatment includes surgical drainage and antibiotics, highlighting the need for further research into specific management strategies.