Pyomyositis
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Inflammation of muscle, which may lead to pus formation and deep-seated muscle abscess.
Cause
- Bacterial infection (commonly Staphylococcus aureus)
Clinical features
- Most commonly localised in one muscle; usually large striated muscle
- Fever, painful swelling of the involved muscle
- Affected area is hot, swollen, and tender
- Fluctuation when pus forms
Differential diagnosis
- Cellulitis, boil
- Osteomyelitis
- Peritonitis (in pyomyositis of abdominal muscles)
Investigations
- Blood: Full blood count
- Pus: culture and sensitivity
- Consider HIV infection
ManagementTreatment
- Elevate and immobilise affected limb
- Cloxacillin 500 mg IV or oral every 6 hours for 5-10 days
- Child: 12.5-25 mg/kg per dose
- During the early stage, when the muscle is indurated, hot and swollen, antibiotic treatment may be sufficient to resolve the infection
When abscess has formed,
- Surgical drainage is the only effective treatment
- Leave the wound open, pack and clean daily