Pyomyositis of the anterior tibial compartment

Five oncology patients developed bacterial pyomyositis involving the anterior tibial compartment and resulting in compartment syndrome with ischemia and abnormalities of neuromuscular function. All patients were neutropenic and thrombocytopenic, and four were receiving or had recently received cancer chemotherapy. Three infections were due to gram-negative bacilli and two to Staphylococcus aureus. Appropriate antimicrobial therapy and surgical drainage in four patients resulted in the resolution of these infections with good residual muscle function. To our knowledge, primary pyomyositis has never previously been known to cause compartment syndrome.