title: Visual diagnosis: 11-year-old boy with leukemia, fever, elbow, and leg pain.
abstract: The diagnosis of pyomyositis requires a high index of suspicion in patients with hematologic malignant neoplasms. Correct diagnosis might be delayed initially because of vague clinical presentation, overlapping symptoms, and nonspecific clinical signs. Pyomyositis should be included in the differential diagnosis when a patient develops swollen or tender muscles after chemotherapy with or without bacteremia. Prompt treatment with broad-spectrum antibiotics that cover S aureus and resistant emerging gram-negative organisms, specifically E coli, should be initiated immediately in patients with hematologic illnesses along with close monitoring and follow-up.
authors.affiliation: Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
authors.forename: Ban
authors.initials: B
authors.lastname: AL-Sayyed
authors.affiliation: Department of Hematology Oncology and Bone Marrow Transplant, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Bayomy
authors.affiliation: Department of Radiology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
authors.forename: Bilal
authors.initials: B
authors.lastname: Rammal
authors.affiliation: Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
authors.forename: Mohannad
authors.initials: M
authors.lastname: Mannaa
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002481:Cellulitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D002648:Child; D004551:Elbow Joint / Q000473:pathology; D004926:Escherichia coli / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005334:Fever / Q000209:etiology; D006801:Humans; D015458:Leukemia, T-Cell / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D010146:Pain / Q000209:etiology; D052880:Pyomyositis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D013848:Thigh
chemical_list: D000900:Anti-Bacterial Agents