title: Pneumococcal pyomyositis: report of 2 cases and review of the literature.
abstract: Streptococcus pneumoniae is an uncommon cause of pyomyositis. It is unclear whether the clinical presentation and outcome of pneumococcal pyomyositis differ depending on the host's underlying immune status. We describe 2 patients with pneumococcal pyomyositis, review all published cases, and compare characteristics between apparently healthy hosts and at-risk hosts. A total of 35 cases of pneumococcal pyomyositis were identified, 11 in apparently healthy hosts and 24 in at-risk hosts. Two-thirds of the patients had an antecedent respiratory illness or meningitis. At-risk hosts tended to have a longer interval between the development of symptomatic muscle infection and the diagnosis of pyomyositis and a significantly higher risk of disseminated disease at presentation, as manifested by involvement of multiple noncontiguous muscles or presence of meningitis. Overall, other than 1 death, all patients recovered with antibiotics and surgical drainage, but as might be expected there was a significantly higher rate of complications among at-risk hosts.
authors.affiliation: Department of Medicine, VA Medical Center, Minneapolis, Minnesota, USA.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Zadroga
authors.forename: Dylan
authors.initials: D
authors.lastname: Zylla
authors.forename: Kelly
authors.initials: K
authors.lastname: Cawcutt
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Musher
authors.forename: Pankaj
authors.initials: P
authors.lastname: Gupta
authors.forename: Michael
authors.initials: M
authors.lastname: Kuskowski
authors.forename: Ayse
authors.initials: A
authors.lastname: Dincer
authors.forename: Anjum S
authors.initials: AS
authors.lastname: Kaka
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000175:diagnosis* / Q000382:microbiology* / Q000473:pathology; D052880:Pyomyositis / Q000175:diagnosis* / Q000382:microbiology* / Q000473:pathology; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents