Pyomyositis caused by extended-spectrum beta-lactamase-producing Escherichia coli in a patient with acute myeloid leukemia.
Pyomyositis is an infection of skeletal muscle that involves the formation of intramuscular abscesses. It occurs most commonly in immunocompromised patients. Pyomyositis caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli has never been reported in the literature. A 48-year-old female patient developed ESBL-producing E. coli bacteremia and pyomyositis on the twelfth day of cefpirome therapy for neutropenic fever after chemotherapy due to acute myeloid leukemia. She recovered completely after a three-week course of meropenem and surgical excision. Pyomyositis should be included in the differential diagnosis when fever and muscular swelling develop in a patient with neutropenic status after chemotherapy. Early recognition of symptoms and proper diagnostic procedures are key to diagnosing pyomyositis. Both adequate antibiotics and surgical intervention are important for the successful treatment of pyomyositis caused by ESBL-producing E. coli.
Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Sheng-Kang
SK
Chiu
Feng-Yee
FY
Chang
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects*; D016470:Bacteremia / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000201:enzymology; D004927:Escherichia coli Infections / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000188:drug therapy; D000077731:Meropenem; D008875:Middle Aged; D052880:Pyomyositis / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D013845:Thienamycins / Q000627:therapeutic use; D001618:beta-Lactamases
D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents; D013845:Thienamycins; D001618:beta-Lactamases; D000077731:Meropenem