Journal List > J Korean Diabetes Assoc > v.30(2) > 1062371

Park, Kim, Jung, Park, Ahn, Lee, Hwang, Lee, Han, Mok, Kim, Park, Kim, Kim, Byun, Suh, and Yoo: A Case of Multifocal Pyomyositis in Diabetes Mellitus


Pyomyositis is an acute bacterial infection of skeletal muscle, usually caused by Staphylococcus aureus. It is common in the tropics but rare in temperate climates. In temperature climate there are predisposing factors, such as diabetes, HIV infection, malignancy. The incidence of reported bacterial pyomyositis is increasing in recently, especially among immunocompromised persons such as HIV infection or diabetes mellitus. We experience multifocal pyomyositis in 49-year-old man with type 2 diabetes mellitus presented with drowsy mental state. Muscular USG and MRI finding shows multifocal abscess in thigh. Blood culture revealed Staphyloccus aureus. And patient received a intravenous broad-spectrum antibiotics, incision and drainage. He was successfully managed with drainage and antibiotics then discharge. Since diabetes or infection with HIV predisposes patients to bacterial infection, pyomyositis will occur more frequently. Increased awareness if the disease will improve management.

Figures and Tables

Fig. 1
Panel A(HAD #8) shows both lung infiltration and right pleural effusion. Panel B(HAD #20); After antibiotics application, both lung field infiltration was improved.
Fig. 2
Ultrasonography shows increased echogenicity and geographic peripheral marginal echogenic lesion in right thigh.
Fig. 3
MRI shows low signal intensity in right thigh mass in T1WI.
Fig. 4
MRI shows high signal intensity in T2WI.


1. Smith IM, Vickers AB. Natural history of 338 treated and untreated patients with staphylococcal septicemia. Lancet. 1960. 1:1318–1325.
2. Crum NF. Bacterial pyomyositis in the United states. Am J Med. 2004. 117:420–428.
5. Seah MY, Anavekar SN, Savige JA, Burrell LM. Diabetic pyomyositis: an uncommon cause of a painful leg. Diabetes care. 2004. 27:1743–1744.
6. Christin L, Sarosi GA. Pyomyositis in North America: Case reports and review. Clin Infect Dis. 1992. 15:668–677.
7. Itzhak brook. Microbiology and management of myositis. Int Orthop. 2004. 28(5):257–260.
8. Patel SR, Olenginski TP, Perruquet JL, Harrington TM. Pyomyositis: clinical features and predisposing conditions. J Rheumatol. 1997. 24:1734–1738.
9. Walling DM, Kaelin WG Jr. Pyomyositis in patients with diabetes mellitus. Rev Infect Dis. 1991. 13:797–802.
11. Chiedozi LC. Pyomyositis. Review of 205 cases in 112 patients. Am J Surg. 1979. 137:255–259.
12. Wysoki MG, Angeid-Backman E, Izes BA. Iliopsoas myositis mimicking appendicitis: MRI diagnosis. Skeletal Radiol. 1997. 26:316–318.
13. Chen WS, Wan YL. Iliacus pyomyositis mimicking septic arthritis of the hip joint. Arch Orthop Trauma Surg. 1996. 115:233–235.
15. Howman-Giles R, McCauley D, Brown J. Multifocal pyomyositis. Diagnosis on technisium-99m MDP bone scan. Clin Med Mar. 1984. 9:149–151.
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