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Acute pyomyositis of the adductor magnus muscle involving the posterior and lateral thigh compartments: a case report of diagnosis and management

  • Bawale, Rajesh (Department of Trauma and Orthopaedics, Medway Maritime Hospital) ;
  • Watson, Jay (Department of Trauma and Orthopaedics, Medway Maritime Hospital) ;
  • Yusuf, Karshe (Department of Trauma and Orthopaedics, Medway Maritime Hospital) ;
  • Pillai, Dilip (Department of Trauma and Orthopaedics, Medway Maritime Hospital) ;
  • Singh, Bijayendra (Department of Trauma and Orthopaedics, Medway Maritime Hospital)
  • Received : 2021.02.16
  • Accepted : 2021.04.21
  • Published : 2022.06.30

Abstract

Bacterial infection of skeletal muscle can lead to the formation of abscesses. Primary pyomyositis is typically seen in tropical countries, and Staphylococcus aureus is the commonest causative organism. We present a case of acute adductor magnus muscle abscess (pyomyositis) with spread to adjacent thigh compartments via the perforators without iliopsoas muscle involvement. Due to the involvement of the entire thigh compartment, systemic antibiotic treatment alone was insufficient, whereas surgical drainage improved the clinical picture. The aetiological organism was S. aureus. Herein, we report the case of a patient who had primary pyomyositis, rather than a secondary type, that spread to the posterior and lateral aspect of the thigh through the second and third perforators, which pierce the adductor magnus muscle belly before entering the femur.

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References

  1. Brown RL. Pyomyositis in patients with diabetes. Computed tomography as a key to diagnosis. Postgrad Med 1989;86:79-89. https://doi.org/10.1080/00325481.1989.11704326
  2. Chalaupka FD. Acute iliopsoas and adductor brevis abscesses presenting with proximal leg muscle weakness. Neurol Sci 2006;27:125-8. https://doi.org/10.1007/s10072-006-0613-z
  3. Christin L, Sarosi GA. Pyomyositis in North America: case reports and review. Clin Infect Dis 1992;15:668-77. https://doi.org/10.1093/clind/15.4.668
  4. Harada K, Kashihara N, Iwamuro M, Otsuka F. Multiple abscesses caused by repetitive intramuscular injections. J Gen Fam Med 2017;18:301-2. https://doi.org/10.1002/jgf2.62
  5. Crum-Cianflone NF. Bacterial, fungal, parasitic, and viral myositis. Clin Microbiol Rev 2008;21:473-94. https://doi.org/10.1128/CMR.00001-08
  6. Pai VS, Yee E, Lawson D, Curtis G. Iliacus pyomyositis with involvement of lateral cutaneous nerve of the thigh. N Z Med J 1994;107:378-9.
  7. Schiff RG, Silver L. Tropical pyomyositis. Demonstration of extent and distribution of disease by gallium scintigraphy. Clin Nucl Med 1990;15:542-4. https://doi.org/10.1097/00003072-199008000-00003
  8. Struk DW, Munk PL, Lee MJ, Ho SG, Worsley DF. Imaging of soft tissue infections. Radiol Clin North Am 2001;39:277-303. https://doi.org/10.1016/S0033-8389(05)70278-5
  9. Arora S, Sabat D, Sural S, Dhal A. Isolated tuberculous pyomyositis of semimembranosus and adductor magnus: a case report. Orthop Surg 2012;4:266-8 https://doi.org/10.1111/os.12011