title: Disseminated community-acquired USA300 methicillin-resistant Staphylococcus aureus pyomyositis and septic pulmonary emboli in an immunocompetent adult.
abstract: BACKGROUND
  Recent reports have increasingly recognized methicillin-resistant Staphylococcus aureus (MRSA) as an important etiology of pyomyositis, an uncommon disease entity. Specific virulence factors such as the Panton-Valentine leukocidin protein have been identified that may play a role in the pathophysiology of pyomyositis, especially when community-acquired MRSA is implicated.
  
  
  METHODS
  We review a case of disseminated pyomyositis and septic pulmonary emboli in an immunocompetent adult in whom a pvl+ USA300 clone was isolated.
  
  
  RESULTS
  The degree of dissemination in this patient suggests an emerging level of virulence for community-acquired MRSA that has not been reported previously.
  
  
  CONCLUSIONS
  The clinical history and management of severe disseminated pyomyositis, including diagnostic modalities, antimicrobial therapy, and surgical drainage, require an aggressive approach.
authors.affiliation: Department of Surgery, University of Washington, Seattle, WA, USA. Joseph.Woodward@ucsfmedctr.org
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Woodward
authors.forename: Dhruba J
authors.initials: DJ
authors.lastname: Sengupta
authors.forename: Brad T
authors.initials: BT
authors.lastname: Cookson
authors.forename: James O
authors.initials: JO
authors.lastname: Park
authors.forename: E Patchen
authors.initials: EP
authors.lastname: Dellinger
mesh_terms: D015373:Bacterial Typing Techniques; D017714:Community-Acquired Infections / Q000382:microbiology; D016172:DNA Fingerprinting; D005838:Genotype; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D009132:Muscles / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000382:microbiology*; D052880:Pyomyositis / Q000150:complications* / Q000175:diagnosis* / Q000382:microbiology; D011859:Radiography; D013203:Staphylococcal Infections / Q000382:microbiology*; D055815:Young Adult