A DIABETIC PATIENT WITH THIGH PYOMYOSITIS

Pyomyositis is a pyogenic infection of the skeletal muscle characterized by muscle pain and swelling. The illness is more commonly seen in the tropics. The diagnosis of pyomyositis is difficult due to its vague clinical presentation and poor localizing signs. The differential diagnosis includes osteomyelitis, septic arthritis, muscle hematoma, muscle rupture and deep vein thrombosis. A delay in diagnosis may result in compartment syndrome, sepsis and death. Pyomyositis can be divided into three clinical stages: Stage 1 is characterized by crampy local muscle pain, swelling, low-grade fever and leukocytosis. The muscle may have a "woody" texture on palpation. Stage 2 is characterized by fever, muscle tenderness, and edema. Aspiration of the affected muscle typically yields pus. Stage 3 is characterized by bacteremia and a toxic appearance. Complications such as septic shock, endocarditis, pneumonia and some others may be present. Definite diagnosis should be made by aspiration or surgical drainage of the abscess. We report a 53 years old patient with diabetes who presented with a swelling and painful buttock and thigh, that was diagnosed with pyomyositis.