Table 3.
Polymicrobial and Other Pyomyositis and Infectious Myositis Cases
| Infection | Age/Sex | Pathogen | Relevant Comorbid Conditions | Area of Involvement | Blood Cultures | Initial Pathogen-Specific Antimicrobial Therapy | Surgical Intervention | Outcome |
|---|---|---|---|---|---|---|---|---|
| Pyomyositis | 80/male | Actinomyces spp | Renal cell carcinoma | Right rectus muscle | Negative | TMP-SMX | IR drainage and biopsy followed by I&D | Success |
| Pyomyositis | 62/male | Eikenella corrodens, viridans Streptococcus | Hereditary hemorrhagic telangiectasia | Right masseter muscle | Negative | Moxifloxacin | Interventional neuroradiology aspiration and biopsy | Success |
| Pyomyositis | 75/female | Escherichia coli | Hemodialysis-dependent end stage renal disease | Left lower extremity | E coli | Ceftriaxone | I&D followed by IR drainage | Clinically stable at discharge then lost to follow up |
| Pyomyositis | 24/female | MSSA, MAC | person with HIV with CD4+ count 3/μL | Left upper extremity | MAC | Nafcillin then clarithromycin, amikacin, ethambutol (added when AFB culture returned) | None | Died months after initial presentation from failure to thrive, disseminated MAC infection, and other complications |
| Pyomyositis | 63/male | MSSA, viridans Streptococcus | Diabetes mellitus, history of intravenous drug use, HBV, HCV | Left upper extremity | Negative | Vancomycin | I&D | Success |
| Pyomyositis | 75/female | Nocardia farcinica | Renal transplant recipient on immunosuppressive therapy, diabetes mellitus | Right lower extremity | Negative | TMP-SMX | IR drainage | Success |
| Myositis | 22/male | CoNS, Cutibacterium acnes | None | Left upper extremity and chest wall | Negative | Cefazolin | I&D | Success |
| Myositis | 36/male | CoNS, Group A Streptococcus | None | Right lower extremity | Negative | Empiric therapy | Fasciotomy | Clinically stable at discharge then lost to follow up |
| Myositis | 43/female | Cryptococcus neoformans | Renal transplant recipient on immunosuppressive therapy, diabetes mellitus | Left lower extremity | C neoformans | Fluconazole, liposomal amphotericin B | None | Readmitted shortly after discharge and died from sepsis |
| Myositis | 35/female | Influenza A | None | Diffuse | Stenotrophomonas maltophilia (from autopsy) | Oseltamivir | Numerous fasciotomy procedures | Death |
Abbreviations: AFB, acid-fast bacillus; CoNS, coagulase negative Staphylococcus; HBV, hepatitis B virus; HCV, hepatitis C virus; HIV, human immunodeficiency virus; I&D, incision and drainage; IR, interventional radiology; MAC, Mycobacterium avium complex; MSSA, methicillin-sensitive Staphylococcus aureus; TMP-SMX, trimethoprim-sulfamethoxazole.