Iliopsoas Pyomyositis With Bacteremia at an Early Stage of Presentation in a Temperate Region

Abstract

A psoas abscess, a collection of pus in the psoas muscle, is rare but the incidence is increasing with the use of computed tomography (CT) and magnetic resonance imaging (MRI). Pyomyositis, a muscular infection that does not lead to abscess formation, is well known as tropical pyomyositis because it is highly prevalent in tropical areas. We encountered a case of iliopsoas pyomyositis and bacteremia without abscess formation. The blood culture was positive despite the early stage of presentation and no abscess formation on MRI. Imaging is the gold standard for diagnosing iliopsoas abscesses. There are cases similar to ours wherein the blood culture is positive before the formation of an abscess. Regardless of whether an abscess is found on MRI or not, we need to consider the possibility of false negatives at the early stage of presentation. A suspicion of this disease is essential during a physical examination for early diagnosis and treatment, especially in rural areas, where medical resources are limited. Furthermore, pyomyositis is a common disease in tropical regions, but in recent years, case reports of occurrences in temperate regions have increased. This case indicates the need to consider pyomyositis as a differential diagnosis of fever and hip joint pain even in temperate regions.

Multiple Prostatic Abscesses Caused by Staphylococcus aureus Without Physical Findings in an Immunosuppressed Older Patient

“…Furthermore, immunocompromised hosts may exhibit vague and multiple symptoms without specific physical findings. To diagnose and treat them, family physicians should order blood cultures and look for infections in deep parts of the body, as in this case, which can clarify the effective management of older immunocompromised patients [ 16 ].…”

Meningitis With Staphylococcus aureus Bacteremia in an Older Patient With Nonspecific Symptoms: A Case Report

“…However, when the immune system is weakened by stress or aging, S. aureus can enter the body and induce infections [ 14 ]. Furthermore, the possibility of bacteremia increases in the case of a compromised epidermis, which is known to comprise substantial S. aureus bacteria [ 15 ]. Considering the present case report, the patient experienced dry skin across the whole body, accompanied by mild bedsores, considered the “gateway for infection.” As frailty progresses, the immune status of the elderly is likely to deteriorate substantially.…”