title: Primary Bacterial Gluteal Pyomyositis: A Rare Disease in Temperate Climates Presenting as Suspected Septic Arthritis of the Hip.
abstract: BACKGROUND
  In nations with temperate climates, primary polymyositis is a rare, life-threatening bacterial infection that can mimic various clinical diseases depending on the area involved, leading to delayed diagnosis and management.
  
  
  METHODS
  We describe a young postpartum woman who presented to the emergency department with hip pain that was initially suspected to be caused by septic arthritis. However, hip arthrocentesis was negative, and a magnetic resonance imaging scan revealed extensive pyomyositis of the gluteal muscles. She underwent surgical debridement and was given parenteral antibiotics with good clinical recovery. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: We emphasize that cases of pyomyositis in temperate countries are often diagnosed late and therefore delay life- and potentially limb-saving treatment. For patients who present with hip and thigh pain and clinical features of sepsis, pyomyositis should be considered in the differential diagnosis and an early magnetic resonance imaging scan should be performed to confirm the diagnosis and reduce the high morbidity and mortality associated with this emerging disease.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Queen Elizabeth Hospital, Gateshead, Tyne and Wear, United Kingdom.
authors.forename: Christopher George
authors.initials: CG
authors.lastname: Ghazala
authors.affiliation: Department of Radiology, Queen Elizabeth Hospital, Gateshead, Tyne and Wear, United Kingdom.
authors.forename: Elena
authors.initials: E
authors.lastname: Fatone
authors.affiliation: Department of Pathology, Queen Elizabeth Hospital, Gateshead, Tyne and Wear, United Kingdom.
authors.forename: Ruth
authors.initials: R
authors.lastname: Bentley
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Queen Elizabeth Hospital, Gateshead, Tyne and Wear, United Kingdom.
authors.forename: Aysha
authors.initials: A
authors.lastname: Rajeev
mesh_terms: D000328:Adult; D001170:Arthritis, Infectious / Q000175:diagnosis*; D002081:Buttocks / Q000382:microbiology*; D003937:Diagnosis, Differential; D005260:Female; D006621:Hip Joint / Q000382:microbiology; D006801:Humans; D018482:Muscle, Skeletal / Q000382:microbiology; D052880:Pyomyositis / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification
keywords: gluteal muscle; postpartum; pyomyositis; sepsis; septic arthritis