Pyomyositis is a suppurative infection of the skeletal muscle; it mainly occurs in immunocompromised patients or, exceptionally, in immunocompetent patients in tropical or other areas. We present a 24-year-old immunocompetent lady with bilateral thigh myalgia and fever. Upon investigation, extensive multifocal bilateral fluid collections involving the extensor muscles of both thighs were demonstrated. Pus aspirate from the involved muscles proved the presence of Staphylococcus aureus. Incision and drainage of the involved muscles were performed with successful and complete recovery.
Urinary bladder paragangliomas are very rare, and the majority are hormonally active. Nonfunctioning paragangliomas are even rarer and more difficult to diagnose because of absence of catecholamine secretion. We present a 27-year-old woman with an asymptomatic paraganglioma of the urinary bladder discovered incidentally in a patient with prior resection of a functional pararenal paraganglioma. Metabolic profiles and cystoscopy were nondiagnostic. We demonstrate the increased sensitivity of I-MIBG SPECT/CT compared with planar scintigraphy for detection of a nonfunctional paraganglioma of the urinary bladder, which makes it valuable in evaluation of functional and nonfunctional paragangliomas.
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