title: Thigh pyomyositis caused by group A streptococcus in an immunocompetent adult without any cause.
abstract: BACKGROUND
  Pyomyositis is typically caused by Staphylococcus aureus, and is rare in temperate climates, although its prevalence has been recently increasing. This infection often involves the thigh, and is associated with immunodeficiency.
  
  
  METHODS
  We report the case of a healthy 20-year-old Japanese woman who experienced a fever and continuous pain for several days. She was admitted to our hospital and was diagnosed with pyomyositis after we discovered an abscess between the muscles of her dorsal distal left thigh using computed tomography. This is a rare case of thigh pyomyositis, as it was caused by group A streptococcus and occurred in an immunocompetent adult from a temperate climate.
  
  
  CONCLUSIONS
  Our review of the literature revealed that group A streptococcus pyomyositis typically occurs in temperate climates, among young adults without any underlying disease, and is associated with a poorer prognosis, compared to general pyomyositis. We suggest that pyomyositis should be considered when immunocompetent adults present with apparently idiopathic inflammatory muscle lesions.
authors.affiliation: Division of General Internal Medicine, Jichi Medical University Hospital, Shimotsuke, Japan.|Department of General Medicine, Toyooka Public Hospital, Toyooka, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Minami
authors.affiliation: Division of General Internal Medicine, Jichi Medical University Hospital, Shimotsuke, Japan. smile.kenzaka@jichi.ac.jp.|Division of Community Medicine and Career Development, Kobe University Graduate School of Medicine, 2-1-5 Arata-cho, Hyogo-ku, Kobe, Hyogo, 652-0032, Japan. smile.kenzaka@jichi.ac.jp.
authors.forename: Tsuneaki
authors.initials: T
authors.lastname: Kenzaka
authors.affiliation: Division of General Internal Medicine, Jichi Medical University Hospital, Shimotsuke, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Kumabe
authors.affiliation: Division of General Internal Medicine, Jichi Medical University Hospital, Shimotsuke, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Matsumura
mesh_terms: D000038:Abscess; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007249:Inflammation; D007564:Japan; D052880:Pyomyositis / Q000000981:diagnostic imaging / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000175:diagnosis*; D013211:Staphylococcus aureus; D013297:Streptococcus pyogenes / Q000302:isolation & purification*; D013848:Thigh / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Group A streptococcus; Immunocompetent adult; Pyomyositis